of All Children Affected by Autism
Remember the impact of seeing the stack of photos of recovered and in the process of recovery from Larry King Live? It's time to do that again – this time in book form.
Deadline Has Been Extended to Include Your
Child and Support Jenny McCarthy’s Efforts
Jenny McCarthy is looking for photos of children for her upcoming book on
recovered kids and kids in process of recovery. This includes all children on the autism spectrum that their families wish to participate.
Your child’s photo should include: Just the photo of the child (no overbearing background, no other family members)
Where to send the photos: recoveredkids@gmail.com
Deadline: Monday, January 15, 2008
Email or mail must include:
- Photo (high quality photo quality JPG format)
- First name of child, age, diagnosis, with title: recovered or in process of recovery
- The agreement below must be FAXED with your authorization to use the photo.
Please note:
- Photos can ONLY BE USED with a signed agreement
- Must include high quality photo scan
- We are sorry – we cannot guarantee your photo will used
THANK YOU!
FAX RELEASE BELOW TO 310-826-8020
Families can opt to fax and email or JUST MAIL the photos and release. To mail both the photo and release to be received BY THE DEADLINE – please mail to:
Ashley Davis
11812 San Vicente Blvd Suite 604
Los Angeles, CA 90049
RELEASE
For valuable consideration (but without fee), I hereby authorize Jenny McCarthy ("AUTHOR") and Dutton, a division/subsidiary of Penguin Group (USA) Inc. ("PUBLISHER"), and their licensees, successors, assigns, heirs and representatives to use my name, likeness, photographs of and information about me, interviews of me and comments that I have made, and materials that I have written, in whole or in part (with possible editorial changes), in the book tentatively titled UNTITLED ON AUTISM (the "Book") by AUTHOR, in all editions, revisions and derivations of the Book in all media, now known or hereafter devised, and in the advertising and promotion thereof, in all languages throughout the world.
I waive and release any claims that I may have against AUTHOR or PUBLISHER, and any of their respective licensees, successors, assigns, heirs or representatives based upon or arising from such uses, including without limitation, any moral rights of whatsoever description, any right to inspect the Book or to approve the references to me therein, any claims for invasion of privacy, violation of the right of publicity, defamation, and copyright infringement or for any fees for such use.
I represent and warrant that I am twenty-one years old or older.
(signature)
Print Name:
Dated: Month, day, 2008
CHILD’S NAME:
IF THE SUBJECT IS UNDER THE AGE OF 21, THE SUBJECT'S PARENT OR AUTHORIZED LEGAL GUARDIAN MUST EXECUTE THE FOLLOWING:
I hereby consent to the above subject's execution of the foregoing waiver and release and the grant of rights contained therein:
(signature)
Print Name:
Dated: Month, day, 2008
Address:
