First Name (required) Last Name (required) Your Pronouns (required) Your Email (required) Your Phone (required) Your County (required) Postal Code (required) Do you hold office in any ArkDems auxiliary, county party or any other entity? If you checked the box above, please explain which office you hold and what group you are a part of. Tell us about your community! Tell us about your community! Tell us about your career! Tell us your Twitter and Instagram handle. Age Do you wish to submit a photo or video? (required) PhotoVideoOther How are you an Everyday Arkansan and how does that make you an Arkansas Democrat? [checkbox checkbox-819 "Please check yes on the Media release form. I, the undersigned, hereby consent to the use by Democratic Party of Arkansas ("DPA"), and those acting with permission and authority of DPA, of all photographs, videotape, or other images or recordings that the DPA has taken of me or in which I may be included, for all purposes, in any and all media including the Internet, without limitation. I am fully aware that my likeness may appear in materials in internal and external communications. I further grant the DPA the irrevocable and unrestricted right and permission to copy/reproduce and distribute my Likeness by means of various media, including, but not limited to video presentations, simultaneous television broadcast/rebroadcast, radio transmission/retransmission, news releases, mail-outs, emails, billboards, signs, brochures, placement on websites and/or other electronic/digital delivery, social media, publication, display, or promotions on any and all other media, and I further understand that My Likeness may be subject to reasonable modification or editing. I hereby waive any right to inspect or approve the finished images or other content, including advertising copy or printed matter, in which they may be used. I release the DPA and those acting under their authority from any liability related to the alteration, intentional or otherwise, that may occur in connection with the processing, editing, transmission, display or publication of the images, and understand that images may be cropped or altered for purposes of illustration. I further waive and release the DPA and its officers, agents and employees from any claim or liability relating to the use of my name, likeness, identity, voice, photographic image, video graphic image and oral or recorded statements, including all claims of compensation, damage for libel, slander, invasion of the right of privacy or any other claims based on, arising out of, or connected with the use of said recordings and/or images. I understand that all images in which I participate, including film, photographic prints, digital files or video are the exclusive property of the DPA and I grant to the DPA the unrestricted right to copyright, publish and re-publish the images."] Δ
