MAIN STAY THERAPEUTIC FARM      6919 KEYSTONE RD    RICHMOND IL, 60071    815.653.9374   CONTACT US

DONATE To encourage, enrich and empower individuals through the therapeutic benefits of horses, animals and nature in an uplifting and nurturing setting. Main Stay is a place where bodies are challenged, minds embrace possibilities, and spirits are renewed.

 

Photo Release for Parent, Spouse, Caregiver or Guardian

I/We :

hereby grant irrevocable and unlimited consent to the use and reproduction by Main Stay Therapeutic Farm, Inc., PATH Intl., its assigns, licensees and legal representatives, of any and all photographs and any other audio/visual materials taken of me, my child or my ward, in all forms and media (including but not limited to printed media, digital media, web sites, video and audio productions). The materials may be reproduced in all forms including composite, altered or derivative works, for promotional material, educational activities, exhibitions or for any other lawful use for the benefit of the program.

I hereby waive the right to inspect and approve the finished version(s) including any copy that may accompany the materials. I hereby release Main Stay, PATH Intl. and its employees, volunteers, assigns, licensees and legal representatives from all claims and liability relating to said materials.

I have read and understand the above release, am over 18 and have the capacity to sign this release of my own free will.

Contact information

Main Stay Therapeutic Farm

6919 Keystone Rd., Richmond, IL 60071

Tel: 815.653.9374  Fax: 815.728.1224

Contact Us

info@mainstayfarm.org

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