“No Man Shall Protect Us” Photo Release Form

Wolf Point Media

1239 West Farwell Ave.

Chicago, IL, 60626

Subject: permission to use photograph in the documentary “No Man Shall Protect Us”

I grant to Wolf Point Media, its representatives and employees the right to use photographs of me and my property in connection with the above-identified subject. I authorize Wolf Point Media, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Wolf Point Media may use such photographs of me with or without my name as illustration in the documentary “No Man Shall Protect Us”.

I have read and understand the above:

Signature _________________________________

Printed name ______________________________

Organization Name (if applicable) __________________________

Address __________________________________

Date ____________________________________

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