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Image Release Form

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  2. RELEASE FOR USE OF IMAGE OR LIKENESS

  3. Contra Costa County is gathering images for a planned launch of a new intranet presence, and we hope to feature pictures from a wide variety of the County workforce on the job and providing public service. In order to use a photo on our intranet, the same rules of use apply that govern internet use of images – the Office of Communications and Media will need your permission to use a photo of you on the job. Unless you specify that the images are for intranet use only, we may also use them for the internet and public outreach materials. By filling out the form below, you give the County of Contra Costa (“County”) the absolute right and permission to the unlimited use of your image and likeness in photographic, video, film, slide, or any other electronic or printed formats as follows:

  4. 1.*

    I understand and agree that the County may use my image or likeness in its educational or promotional materials, publicity efforts, or for any other lawful purpose.

  5. 2.*

    2. I understand and agree that these materials will become the property of the County and will not be returned;

  6. 3.*

    3. I understand and agree that the County shall have the right to use my image or likeness in any display, publication, print ad, direct-mail piece, or electronic media, including, but not limited to, video, online, email, or television;

  7. 4.*

    4. I understand and agree that the County’s use of my image and likeness will be without any compensation to me or my heirs or assigns.

  8. 5.*

    I authorize the County to edit, alter, copy, exhibit, publish or distribute my image or likeness for these purposes.

  9. 6.*

    I waive the right to inspect or approve the finished product in which my image or likeness appears.

  10. 7.*

    7. I release and hold harmless the County, the photographer, their officers, employees, agents, and designees from any liability, claims, demands, causes of action, or attorneys fees regarding the use of my image or likeness, including for violation of any personal or proprietary right I may have in connection with such use.

  11. I am 18 years of age or older, have read and understand this release, and agree to this release voluntarily.*

  12. Leave This Blank:

  13. This field is not part of the form submission.