The Midwest Trans Youth Conference is a weekend conference dedicated to transgender, gender nonconforming, questioning and SOFFA youth ages 24 and under.

PHOTO RELEASE

(print friendly form)

I,                                                          , knowingly and voluntarily give the Milwaukee Lesbian/Gay/Bisexual/Transgender Community Center, Inc. (“Milwaukee LGBT”), its employees and agents permission to use my likeness in a photograph in any and all publications for the Milwaukee LGBT, including web site entries, without payment or any other type of consideration in perpetuity.  I understand and agree that these materials will become the property of the Milwaukee LGBT and will not be returned.

I hereby irrevocably authorize the Milwaukee LGBT to edit, alter, copy, exhibit, publish, register for copyright or distribute such photographs for purposes of publicizing the Milwaukee LGBT programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears.

I hereby hold harmless and release and forever discharge the Milwaukee LGBT from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

I am 18 years of age or older 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.

Signature/Date

                                                                                  
Printed Name

                                                                                  
Address

                                                                                  
City State Zip Code

                                                                                  
Phone

If the person signing is under age 18, there must be consent by a parent or guardian, as follows:

I hereby certify that I am the parent or guardian of                                    , named above, and do hereby give my consent without reservation to the foregoing on behalf of this person.

Parent or Guardian's Signature/Date

                                                                                     
Parent or Guardian's Printed Name/Date

Did you complete the other forms?

Please fill out and sign the following forms, based upon your age (under 18 or 18+).  If you are under the age of 18, please make sure that you get a parent or guardian signature on all forms and send them in prior to the conference to make sure that the organizers have these forms.  If you are under 18 and do not have these forms, you will not able to participate in the conference.  If you do not wish to be photographed, do not fill out the photo release form.

• Under 18 form (or printfriendly form click here)

• Over 18 form (or printfriendly form click here)