Publication Release Form

I do hereby release the Society of Creative Anachronism, Inc. and the Barony of Caer Anterth Mawr from any claims by myself or any heirs, for use or the photographs, video/moving picture film. or television likenesses taken of me or stories in which my name was used, and that the aforementioned orgainization may use the same for may purpose required in promotional publications, advertising, educational presentations or any purpose sponsored by the SCA and/or Barony.

Name of event, publication, etc: __________________________________________________________

Date: __________________________________________________________

Signature (or signature of parent or legal guardian if under the age of 18): __________________________________________________________