Media release form

Note: This form is to submit photos and images of adults only. To submit photos and images of minors, use the minor release form. To submit documents, use the Document Release Form.


Format accepted: JPG or PNG. Maximum file size: 10MB

To submit other type of photo/image, please contact the IAHPC Team.

As the owner of the copyright of the photo/image described below, I  hereby grant and authorize the International Association for Hospice and Palliative Care, Inc. (“IAHPC”), a Texas nonprofit corporation the right to use any photo and/or image in any lawful organizational materials, including, but not limited to, newsletters, announcements, flyers, posters, brochures, fundraising letters, annual reports, press releases, websites, social networking sites and other print and digital communications, without payment or any other compensation. This authorization extends to all languages, media, formats and markets now known or later discovered.

Whenever provided in physical format, I understand and agree that these materials shall become the property of the IAHPC and will not be returned.

This authorization shall continue indefinitely, and I may revoke it at any time by submitting a notice in writing to the IAHPC.

I hereby hold harmless and release the IAHPC from all liability, petitions, and causes of action which I, my heirs, representative, executors, administrators, or any other persons may make while acting on my behalf or on behalf of my estate.