Photo and video waiver

Sections

The undersigned appeared in a video recording, sound recording or photograph made by the City of Bloomington. The undersigned was a voluntary participant and agreed to appear in the production without a fee, salary, payment, remuneration or other compensation for the appearance now or in the future.

The undersigned understands and agrees that the City of Bloomington has exclusive and entire rights to showings, exhibitions, telecasts, broadcasts, rebroadcasts, and reproductions of this property by any means, including the sharing of this property with third parties. Said rights include sound and silent, color and black and white. The undersigned also states that the undersigned is 18 years old or older.

I agree that by entering my name into the boxes below and then clicking the "Submit" button on this form, I am providing an electronic signature with the legal standing of a handwritten signature. My signature serves to attest that the responses I have supplied via this form are truthful, accurate and complete.

You must be logged in to view this page.

Photo and video waiver

Tennessen warning
Please take notice that any data received by the City as the result of submitting this form will be classified as government data pursuant to the Minnesota Government Data Practices Act, Minnesota Statutes Chapter 13. Under the Data Practices Act, some or all of this data is classified as public data, including your name, address, email address, phone number, and other personal information provided by you. Public data is available to anyone requesting it and consists of all data furnished via this Web form. Please be advised that the correspondence will be added to the public record. The purpose and intended use of the information collected through this form is to obtain public input and data in support of City activities and services. You have the right to refuse to submit this form. If you choose not to submit this form, you will need to contact the City by another means if you wish to provide the information collected by the form.

Nondiscrimination and accommodation commitments
The City of Bloomington does not discriminate on the basis of disability in the admission or access to, or treatment or employment in, its services, programs, or activities. Upon request, accommodation will be provided to allow individuals with disabilities to participate in all City of Bloomington services, programs, and activities. Upon request, this information can be provided in Braille, large print, audio tape and/or electronic format.