We’d love to display your baby pictures in our office and possibly on our website with only your baby’s first name and last initial, but, of course, we need your permission to do so. Please click the waiver below, then upload your pictures.
Waiver

We hereby grant the Empire OB/GYN permission to use my baby’s likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including website publications, without payment or other consideration.

We understand and agree that all photos will become the property of Empire OB/GYN and will not be returned.

We hereby irrevocably authorize Empire OB/GYN to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein our baby’s likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo(s).

We hereby hold harmless, release, and forever discharge Empire OB/GYN from all claims, demands, and causes of action which we (the parents), our heirs, representatives, executors, administrators, or any other persons acting on our behalf or on behalf of our estate have or may have by reason of this authorization.