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Michelle Zelsman, Realtor

Madison Street Tattoo

Dominion Security Systems

Photo and Video Consent Form


Event Name: Ultimate Old Town Alexandria Scavenger Hunt
Date: December 9, 2023

I, the undersigned, hereby grant permission to Michelle Zelsman, Realtor; Madison Street Tattoo; Dominion Security Systems ("the Organizations") and their representatives to take/use photographs and/or videos of me during the above-mentioned event. I understand that these photographs and/or videos may be used for future promotional materials and online content for the Organizations' events.

I authorize the Organizations to use, reproduce, and distribute these photographs and/or videos in print, electronic, or any other media formats, without limitations. I also understand that my name, if used in conjunction with the photographs and/or videos, will be used for identification purposes only.

I waive any right to royalties or other compensation arising or related to the use of these photographs and/or videos. I understand that the Organization will make every reasonable effort to use these photographs and/or videos responsibly, but I release the Organization and its representatives from any liability arising from such use.

I acknowledge that I have read and understood the terms of this consent form, and I voluntarily agree to its provisions.

Photography & Video
Consent & Release Form

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