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City of Orem

pwolfley@orem.org

56 N. State St., Orem, UT, 84057, US

Property All-Star Signup Sheet

Please input your information and then submit your before and after photos at the bottom. The more photos the better.

Full Name

Full Address

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By entering the “Property All-Star Program”, I hereby grant the City of Orem (the “City”) permission to use my photographs or electronic images, name, and address for any purpose and in any format the City elects, without payment, royalties, or any other consideration. I grant the City of Orem a consideration-free, perpetual, non-exclusive license to publicly display, distribute, reproduce, alter, copy, publish, and create derivative works of the photographs or electronic images, which may include my name and address, for any purpose, including, but not limited to, advertising and promotion of the City of Orem in any media now existing or later developed. Any photograph or electronic image reproduced will include a photographer credit as feasible. I waive the right to inspect or approve any finished product, including written or electronic copy, wherein my photograph, electronic image, name, or address appears. I hereby hold harmless, release and forever discharge the City from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I am 18 years of age and am competent to contract in my own name, or if I am under age 18, a parent or guardian has signed below. I have read this release before signing below and I fully understand the contents and impact of this release.

Applicant's Signature (if 18 or older) or parent or guardian of applicant

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Full Date

If the person signing is under age 18 a parent or guardian must also sign below: I hereby certify that I am the parent or guardian of:

named above, and do hereby give my consent without reservation to this release on behalf of this person.