I hereby grant the Rochester Police Department permission to use the likeness of my family member/victim in a photograph, video, digital media, departmental website or any social media platforms, without payment or other consideration, for the purpose of soliciting information leading to the arrest and conviction of the person(s) responsible for the death family member.

I understand and agree that all photos will become the property of the Rochester Police Department and will not be returned.

I hereby irrevocably authorize the Rochester Police Department to edit, alter, copy, exhibit, publish any photos received and waive any right to inspect or approve the finished product wherein the likeness of my family member appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.

I hereby hold harmless, release, and forever discharge the Rochester Police Department from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate may have by reason of this authorization.

I HAVE READ AND UNDERSTAND THE ABOVE PHOTO RELEASE AND WAIVER AS EVIDENCED BY MY SIGNATURE BELOW.
NOTE: Please Verify that the Victim’s Name and Report # are the same as on the website

Electronic Consent Form

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Step 1 of 2

You as a family member submit the info/pictures, must be appropriate and it then must be approved by HRT and RPD.