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2. Checking here acknowledges the Use of Photo Consent terms*

   By checking this box, I allow the County Commissioners of Calvert County ("County"), its directors, agents, employees, and contractors to reprint, reuse, display, copy, reproduce, post, publish, exhibit, and distribute the photo(s), which I have submitted herewith, in any media or format for an unlimited amount of uses over an unlimited time period. Use of the photograph(s) is granted at no charge to the County. The County has sole discretion to crop, edit or otherwise enhance the images. I certify and attest that the images submitted are my original work and, if copyrighted, that I am the sole copyright owner and knowingly grant the rights contained herein. I also attest to have consent of anyone clearly depicted in images submitted, and agree to provide proof of consent upon request. I also agree to indemnify and hold harmless the County from and against all claims, actions, proceedings, damages, losses, liabilities, and costs that may arise from or related to any infringement on any intellectual property rights or other rights of a third party.

   1. I Agree
4. Releasor's Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. If the Releasor is under 18 years of age, a parent or guardian must sign below. I, the undersigned, am the parent or legal guardian of the above mentioned minor and have the legal right and authority to execute the above release on behalf of the minor.
19. Parent / Guardian Name
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field