Photo Mosaic Entry Form

About
 
The COVID-19 pandemic and the pharmacy heroes who served the patients and communities it affected have left an indelible mark on the profession and public health at large. The APhA Foundation wants to collect and preserve these images forever.
 
Send us photos that visually capture pharmacy teams’ incredible contributions to COVID-19 response efforts—the people and the places where it all happened. These photos and images will be arranged into a beautiful mosaic.
 
Questions? Please contact info@aphafoundation.org or visit aphafoundation.org/covid-19-heroes-campaign for more information.

Terms and Conditions

I permit and authorize the APhA Foundation (the “Foundation”) and its employees, agents, representatives, contractors, and personnel who are acting on behalf of the Foundation to create and/or obtain and use my photograph, my name, or other likeness of myself (hereinafter collectively referred to as “My Likeness”) for purposes related to the educational mission of the Foundation, including instructional and/or educational purposes, publicity, marketing, and promotion of the Foundation and its various programs without compensation to me.

I understand My Likeness may be copied/reproduced and distributed by means of various media, including, but not limited to, video presentations, mail-outs, e-mails, brochures, placement on websites and/or other electronic delivery, publication, display, or promotion on any and all other media, and I further understand that My Likeness may be subject to reasonable modification or editing. I acknowledge that the Foundation has the right to make one or more photographs or other electronic reproductions of My Likeness in accordance with this Authorization for Use of Image or Likeness (hereinafter sometimes referred to simply as “this Authorization”). I waive any right to inspect or approve the finished product or material in which the Foundation may eventually use My Likeness.

I relinquish and give the Foundation all rights, title and interests in and to My Likeness, including any copyright therein. This Authorization shall be binding upon my heirs, successors, assigns, and legal representations.

I understand that, although the Foundation will endeavor to use My Likeness in accordance with standards of good judgment, the Foundation cannot warrant or guarantee that any further dissemination of My Likeness will be subject to Foundation supervision or control. Accordingly, I release the Foundation from any and all liability related to the dissemination, reproduction, distribution, and/or display of My Likeness in print or any and all other media, and any alteration, distortion or illusionary effect of My Likeness, whether intentional or otherwise, in connection with said use. I also understand that I may not withdraw my permission for use of My Likeness which was granted in this Authorization.

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