RELEASE FORM

I, (your name)_____________________________, authorize and release the likeness of my deceased child, immediate family member, _________________________________ (victim name & relationship to you), age _________ (18 or under) to be rendered in portrait form by a Faces Project artist for public display, to include the internet, in one or more memorials dedicated to bringing awareness to the loss of young lives associated with gun violence in America.
I understand that no commercial profit is to be made from this display and that all non-electronic materials submitted to the artist will be returned. In return for this permission, I will receive one copy of the portrait for my own personal use.

Signed ___________________________________ (family member of victim)
Address: _________________________________________________________________
Phone Number:  __________________________________
Email: _________________________________

Mail with a good copy of a favorite photo(face only will be painted) to:
Christine Ilewski, 436 Bluff St., Alton, IL 62002