Media Release Form

Media Release

Fill out our quick form regarding the use of your Company's logo and likeness.

Name

First Last

Phone

Company Name

Website

Consent(Required)

I authorize Grasshopper Bank the right and permission to use the Company's name as well Company's images, likeness(es), copyright(s), trademark(s), artwork, tagline(s), insignia, indicia, and/or logo(s) without limitation as to duration or frequency of usage in perpetuity, for any purpose, including but not limited to editorial, advertising, and promotion, unless otherwise agreed upon in writing by both parties.

I have the full right and authority to enter into this agreement concerning the Company's name, images, likeness(es), logo(s), and/or signage and do not need the consent or permission of any other person, firm or corporation in order to use the Company name, images, likeness, logos, and/or signage as described above.

I hereby release Grasshopper Bank from any and all claims and demands arising out of or in connection with the use of the Company name, images, likeness(es), logo(s), and/or signage.

File(s)

Drop files here or

Max. file size: 50 MB.

CAPTCHA