Permission & Release Form

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Please complete the following form. You will receive a confirm in email upon completion. Thank you!

Permission & Release Form

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Permission & Release Agreement

I grant to Ori'Zaba's Scratch Mexican Grill, its affiliates, agents, employees, and assignees, the right to take photographs/video/film of me and my property and I authorize Ori'Zaba's Scratch Mexican Grill, its designees, and transferees to copyright, to use and publish the same in print and/or digitally. I also grant to Ori'Zaba's Scratch Mexican Grill, its agents, employees, and assignees, the right to use photographs/video/film of me and my property provided to Ori'Zaba's Scratch Mexican Grill by myself or by my authorized third-party designee; and I authorize Ori'Zaba's Scratch Mexican Grill, its designees and transferees to use and publish the same in print and/or digitally. I agree that Ori'Zaba's Scratch Mexican Grill may use such photographs/video/film/audio footage of me, in whole or in part, with or without my name (first name only for individuals under age 18) and for any lawful purpose, including, but not limited to, such purposes as publicity, illustration, advertising, and web content. I acknowledge that I will receive no monetary payments for my appearance or participation. I waive the right to inspect or approve the finished photographs and any copy that may accompany them. I have read and understand the above:

Are you 18 years of age or older?

Guardian Signature

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