Shifting The South PAC – Photo, Video, and Testimony Release Form

Name of Participant (Print Clearly):
Email (Optional):
Phone Number (Optional):

I hereby grant Shifting The South PAC (“STS PAC”) the irrevocable right and permission to use my image, voice, written or spoken testimony, name, and/or likeness as recorded in photographs, video, audio, or written form for use in any and all media, now known or later developed, including but not limited to promotional materials, public communications, social media, websites, advertising, printed materials, and press releases.

I affirm and acknowledge the following:

  • 1. Voluntary Participation: My participation is entirely voluntary. I have not been paid, compensated, or promised any form of payment or benefit in exchange for my photo, video, statement, or appearance.
  • 2. Ownership and Use: I understand that STS PAC will own the recordings or materials and may edit, use, reproduce, publish, or distribute them without further permission from me and without any obligation to me.
  • 3. No Time Limit: I grant this permission in perpetuity, without any time restrictions, and waive any right to inspect or approve the final materials.
  • 4. No Liability: I release Shifting The South PAC, its officers, representatives, affiliates, and assigns from any and all claims or liability in connection with the use of my likeness or testimony.

By signing below, I confirm that I am at least 18 years of age and have read, understood, and voluntarily agree to the terms of this release.

Signature:
Print Name:
Date:

If the participant is under 18, a parent or legal guardian must sign below:

Parent/Guardian Signature:
Print Name:
Date:
What is a PAC?

A Political Action Committee (PAC) is an organization formed to raise and spend money to influence elections or legislation. PACs support candidates, policies, or causes that align with their mission by funding campaign efforts and promoting civic engagement. They play a key role in amplifying the voices of people and communities in the political process. Shifting The South PAC is dedicated to energizing and empowering Southern communities through progressive action, inclusive leadership, and grassroots advocacy.