When

Monday, June 21, 2021 from 7:00 PM to 8:15 PM CDT
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Where

This is an online event. 
 

 
 

Contact

Cynthia Lipsey 
Justice Journey Alliance™, Leadership Foundation of Chicago 
833-552-2018 ext 3 
info@thejja.org 
 

JustUS Conversations with a Black Pastor: A Two-Part Series  | Session 1 

PHOTO, VIDEO RECORDING, AND AUDIO RECORDING   

RELEASE AND CONSENT FORM  

 I, the undersigned, consent to the recording and any use by Justice Journey Alliance, its officers, agents, employees, successors, licensees, and assigns (collectively, “JJA”) of me, my image, and my voice in the photographs, video recordings, and/or audio recordings taken during  The Justice Lecture Series, JustUS Conversations, THR!VE Pastors Cohort, Beyond Words events. 

 In addition, I waive all claims to compensation (including royalties) or damages based on the use of my name, image, and/or voice, by JJA. I also waive any right to inspect or approve any finished photographs, video recordings and/or audio recordings.  

 I understand that the photographs, video recordings, and/or audio recordings may be used in whole or in part, alone or with other recordings.  

 I understand that the photographs, video, and/or sound recordings may be used for any educational, institutional, scientific, promotional, or informational purposes whatsoever.  

 I understand that JJA has the right to copy, edit, alter, retouch, revise and otherwise change the photographs, video recordings, and sound recordings at JJA’s discretion. All right, title, and interest in the photographs, video recordings, and sound recordings belong solely to JJA.   

  I understand that this consent is perpetual, that I may not revoke it, and that it is binding on myself and my heirs and assigns. I warrant that I am at least 18 years of age and that I am competent in my own name insofar as this consent is concerned.   

 I further attest that I have read this consent form and fully understand its contents.  

 I irrevocably give consent to JJA forever to make use of my image, likeness, appearance, and voice in photographs, video recordings, and sound recordings as described above. I acknowledge that I am fully aware of the contents of this form and am under no disability, duress, or undue influence at the time of my consent of this instrument.