Consent form

In order to share your Spark story or video on the MaineSparks.net website, we want to be absolutely sure you want us to do so!  So, please print and complete this form and send it to the address at the bottom. Thanks so much for sharing!

The publisher of the MaineSparks.net website is TheCompass LLC. For further information, please contact us at mainesparks21@gmail.com.

I, _________________________, grant the publisher of the MaineSparks.net website permission to distribute my likeness and voice on a video, audio, photographic, digital, electronic or any other medium (collectively referred to as ‘the recordings’).

The MaineSparks.net website may use my name in connection with these recordings and may also use, reproduce, exhibit or distribute in any medium (e.g. print publications, video tapes, CD-ROM, Internet/WWW) these recordings for any purpose that the publisher of the MaineSparks.net website, and those acting pursuant to its authority, deem appropriate, including promotional or advertising efforts.

I also allow the MaineSparks.net website to publish the text and/or transcript of my spoken words. Publication may include print publications, video tapes, CD-ROM, and/or Internet/WWW distribution.

Signature: _______________________________________

Date: ______________________

Please return form to:

  • The Compass LLC
  • Publisher of MaineSparks.net
  • Attention: Jay Collier
  • 35 Winter Street
  • Topsham, ME 04086

1/17/2012

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