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Empower Insurance Services LLC
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Term Life Insurance
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Empower Federal Credit Union Amphitheater
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Digital Photo Release
Digital Photo Release
Photo Release Consent
By checking the box below and submitting this form, I, the undersigned, grant Empower Federal Credit Union permission to take photographs of me and/or my minor child (a person under the age of 18). I also authorize Empower Federal Credit Union to use the finished photographs for any legitimate purpose they deem appropriate, including but not limited to marketing, social media, and promotional materials. Furthermore, I relinquish and transfer all rights, title, and interest in the finished photographs, negatives, reproductions, and copies of the original prints to Empower Federal Credit Union, without expectation of compensation.
Adult Release (18+)
Name
Date
Adult Consent
I agree to the terms above and consent to the use of my photograph.
By checking this box, you agree to the terms of this release form and that the checkbox is intended to serve as your signature.
Minor Release (Under 18)
Minor Child(ren)
I agree to the terms above and consent to the use of my child(ren)’s photograph.
By checking this box, you agree to the terms of this release form and that the checkbox is intended to serve as your signature.
Name of Child or Children
Date
Parent or Guardian Name
Phone Number