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Photo & Video Release Waiver

Your signature on this page gives ANCOR, the ANCOR Foundation, and the partners of ANCOR and the ANCOR Foundation permission to use your likeness/information for the specific purpose listed below.

I, the undersigned, do hereby consent and agree that ANCOR, the ANCOR Foundation, and the partners of ANCOR and the ANCOR Foundation can use my likeness as captured in photos and images in its communications and outreach collateral, including but not limited to ANCOR- and ANCOR Foundation-owned websites, print materials, social media profiles, print and digital publications, and elsewhere.

These images and video will be used for purposes that include, but are not limited to, educating the general public, creating awareness of I/DD services and supports, advocating on behalf of I/DD services and supports, soliciting partners to participate in key initiatives, and others. I understand and agree that once information is released or published, ANCOR and the ANCOR Foundation will not be able to control nor limit the extent of its publication, exposure, republication, use or redistribution.

Release Waiver

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Participant Name(Required)
Parent/Guardian Name (if Participant is younger than 18 years of age)