<form-template> <fields> <field class="header" type="header" label="PHOTO/VIDEO CONSENT AND GENERAL RELEASE FORM" subtype="h1"></field> <field class="paragraph" type="paragraph" label="I hereby authorize the R.M. of De Salaberry to use pictures of me (or my child/ward) taken in a photograph, digital image, videotape, motion picture, and/or testimonial (written words). The undersigned hereby releases the R.M. of De Salaberry, its agents or employees, as well as any or all users and exhibitors of said pictures, from any and all claims, demands, accountings, and causes for which the aforesaid videotapes, testimonials, motion pictures, digital image, or photograph likeness may be used pursuant to the Consent and General Release. It is also my understanding that I will receive no compensation for my likeness or testimonial." subtype="blockquote"></field> <field class="form-control calendar" type="date" name="date-1583260499095" label="Date Field"></field> <field class="form-control text-input" type="text" name="text-1583260524424" label="Signature:" subtype="text" required="true"></field> <field class="form-control text-input" type="text" name="text-1583260550538" label="Printed Name:" subtype="text" required="true"></field> <field class="form-control text-input" type="text" name="text-1583260567553" label="Name of person(s) in photo, if different:" subtype="text" required="true"></field> <field class="form-control text-input" type="text" name="text-1583260661889" label="Mailing address:" subtype="text" required="true"></field> <field class="form-control text-input" type="text" name="text-1583260734814" label="Phone(s):" subtype="text" required="true"></field> <field class="form-control text-input" type="text" name="text-1583260811729" label="Email:" subtype="text" required="true"></field> <field class="form-control text-input" type="text" name="text-1583260830414" label="Date:" subtype="text"></field> <field class="form-control text-input" type="text" name="text-1583260910727" label="witness signature:" subtype="text" required="true"></field> <field class="form-control text-input" type="text" name="text-1583869702249" label="Witness Printed name:" subtype="text" required="true"></field> <field class="form-control file-input" type="file" name="file-1583870095996" label="File Upload"></field> </fields> </form-template> Submit Submitting...
