CFS Media Release Form

I hereby grant to BHSSC – Black Hills Special Services Cooperative (hereafter referred to as BHSSC) permission and consent to publish my name and photograph (and by video photography) my image for use in BHSSC's videos, printed publications, websites, and social media, and to freely use such images in the exhibition, advertising, editorial use and publicizing thereof as BHSSC, its assigns, successors and licensees may elect. I acknowledge that since my participation in videos, print publications, websites, and social media produced by BHSSC is voluntary, I will receive no financial compensation. I further agree that my participation in any videos, print publications, websites, and social media produced by BHSSC confers upon me no rights of ownership whatsoever. I also release BHSSC, its contractors, and its employees from any and all liability for any claims by me or any third party in connection with my participation.

I hereby grant to BHSSC – Black Hills Special Services Cooperative (hereafter referred to as BHSSC) permission and consent to publish my child's name (listed in this agreement) and photograph (and by video photography) my child's image for use in BHSSC’s videos, printed publications, websites, and social media, and to freely use such images in the exhibition, advertising, editorial use and publicizing thereof as BHSSC, its assigns, successors and licensees may elect. I acknowledge that since my participation in videos, print publications, websites, and social media produced by BHSSC is voluntary, I or my child will receive no financial compensation. I further agree that my child's participation in any videos, print publications, websites, and social media produced by BHSSC confers upon me or my child no rights of ownership whatsoever. I also release BHSSC, its contractors, and its employees from any and all liability for any claims by me, my child, or any third party in connection with my child's participation.