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2. 
3. Buffalo Tree Trek Activity Submission Form
5. First Name*
6. Last Name*
8. Phone Number*
9. Email Address*
11. Photo Release Agreement*

    By uploading and submitting your photos, the participant(s) agree to: 

    This Authorization and Consent to Use Photograph or Image is given by the undersigned to the City of Buffalo for use by the City of Buffalo.

    This permission form is being granted to the City of Buffalo and any designated agents (photographers, etc.) to take/use pictures of the said person, and that these photos may be used to promote the City of Buffalo via our City website and or social media accounts.

    A Photo Release Authorization Form is a document signed by said person granting permission for use of their photograph. It is a blanket authorization that covers a range of circumstances and does not expire. Since this release is voluntary, it may be revoked at any time by said person in photograph.

    1. Agree
    2. I do not approve the use of my photos
13. Name(s) of individual in Photo 1
14. Name(s) of individual in Photo 2
16. Photo 1*
17. Photo 2*
19. Name(s) of individual in Photo 3
20. Name(s) of individual in Photo 4
22. Photo 3*
23. Photo 4*
25. Name(s) of individual in Photo 5
26. Name(s) of individual in Photo 6
28. Photo 5*
29. Photo 6*
31. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    Plus by signing you are agreeing that If a child is under the age of 18, the parent or guardian are in agreement and approve for the use of their photos. 

    1. I agree.
33. Electronic Signature*
34. Date Agreed*
    Date Agreed
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit Submit and Print

* indicates a required field