Photo of the Month NameThis field is for validation purposes and should be left unchanged.Name(Required) First Last Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) Photo Location(Required)Upload your high resolution photo(Required) Drop files here or Select files Accepted file types: jpg, jpeg, gif, png, Max. file size: 4 MB. License and Release(Required) I agree to the license and release policy.1. You are at least 18 years old. 2. You own the copyright to the Photo, or have the permission of the copyright owner to submit the Photo, and the Pennsylvania Senate’s rights to use the Photo as described in paragraph 4, will not infringe or violate any rights of any third party. 3. You grant the Pennsylvania Senate a royalty-free, nonexclusive, irrevocable license to copy, create derivative works, and publicly distribute, display the Photo worldwide in any and all formats, whether in print or electronically. 4. The Photo is provided to the Pennsylvania Senate without any expectation of compensation, either now or in the future, and you hereby waive any claim against the Pennsylvania Senate for compensation. 5. The Pennsylvania Senate may publish your name in connection with the Photo. 6. For any other individual appearing in the Photo, you have received his or her written consent. 7. You release and agree to hold harmless and indemnify the Pennsylvania Senate, its employees and agents against liability, including costs, for actual or alleged direct or indirect infringement of, or inducement to infringe, any copyright or trademark arising out of the Pennsylvania Senate’s use of the Photo, and any actual or alleged violation of an individual’s privacy and/or publicity rights, provided you are reasonably notified of such claims and/or proceedings.
