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This form must be filled out in its entirety in order for a photograph to be eligible for the contest. A new form should be submitted for each photograph that you plan to submit. After filling out this form, you will need to attach your photograph to an email and send it to The subject line of this email must be in the format "AHS Photo Contest_Last Name."

Image / Photograph Release

By submitting an image and this form you are agreeing that you give the Alaska Herpetological Society (AHS) their assigns, licenses, and legal representatives the irrevocable right to use the image / photograph and its associated data in all forms and media and in all manners, including composite or purpose, and you waive any right to inspect or approve the finished product, including written copy, that may be created in connection therewith. You agree that this image / photograph is your personal property and that you have the right to submit it as part of this contest. You also agree that this releases the AHS and any and all of its representatives from any and all monetary obligations or payments to you or any or all of your authorized representatives for use of the image / photograph and associated data.

First Name:*

Middle Initial:

Last Name:*




Date Photo was Taken:*

Location Photo Was Taken (Be as Specific as Possible):*

Species Depicted in Photo (if known):

Tell us a bit about the circumstances surrounding this photo:*

Tell us a bit about you:*


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