Media Release

By signing this release form, I authorize Open Harvest Co-op Grocery to use the following personal information:

1) My picture – including photographic, motion picture, and electronic (Video) images.
2) My voice – including sound and video recordings.

I hereby grant to Open Harvest, its subsidiaries, licensees, successors and assigns, the right to use, publish and reproduce, for all purposes, my name, pictures of me in film or electronic (video) form, sound and video recordings of my voice, and printed and electronic copy of the information described in sections (1) and (2) above in any and all media including, without limitation, cable and broadcast television and the Internet, and for distribution, promotion, advertising, sale, meetings, and in brochures and other print media. This permission extends to all media, formats, markets and languages now known or hereafter devised.

This permission shall continue forever unless I revoke the permission in writing.

I acknowledge that since my participation with Open Harvest is voluntary, I will receive no financial compensation.

I waive the right to inspect or approve finished photographs, audio, video, multimedia, or advertising recordings and copy of printed matter or computer-generated scanned image and other electronic media that may be used in conjunction therewith or to approve the eventual use that it might be applied to.

    I am at least 18 years of age and am competent to contract in my own name. I have read this release before signing below and I fully understand the contents, meaning, and impact of this release.

    Looking for a paper copy or Media Denial form? Click below to download.