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Village of Glen Ellyn

535 Duane Street, Glen Ellyn, IL, 60137, US


Form Section 1

Glen Ellyn Photo Contest

Adult Photo Release Form

Ages 18 and Over

I hereby grant the Village of Glen Ellyn permission to use my photograph(s) in any and all publications for Government or non-government purposes, including web site entries, without payment or any other consideration in perpetuity.

I hereby authorize the Village of Glen Ellyn to edit, alter, copy, exhibit, publish or distribute this photo. I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my photo appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph(s).

I hereby hold harmless and release and forever discharge the Village of Glen Ellyn from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf of on behalf of my estate which may have or may have by reason of this authorization.

I am 18 years of age or older and am competent to contract in my own name. I have read this release, and I fully understand the contents, meaning, and impact of this release.

Photographer Name
Photographer Address
Date Submitted
Date Picker

Please attach below up to five (5) photos for your submission.  Please title each photo.

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