SCA Video Release Form - Northshield
By filling out this form and attaching my legal name to it, I hereby grant permission to the SCA for the videos of me to be used as follows, according to my selections below.  

I affirm and agree:
1. That this agreement shall be binding upon me and my heirs, legal representatives and assigns.
2. that I am over the age of majority and at least eighteen years of age and legally able to sign this release on my own behalf. If I am not, the name and affirmation of my legal guardian appear below as authorization for this use.
3. to indemnify and hold harmless the SCA in the event any claim is brought against the SCA by any person claiming that this Release is not valid and enforceable or that I did not have lawful authority to grant the above permission and rights to the SCA.

If I am executing this Release as a Parent or Guardian, I consent to the use of my child's video or photograph as set out below, and I agree that if despite the Release, my child makes a claim against the SCA, I will hold harmless and indemnify the SCA for any damages it may incur as a result of said claim.

I have read the above Release prior to its execution and fully understand the contents and consequences thereof.
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Your SCA name, no titles needed. *
Type of Release Consented To *
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