Revival Vintage Eyewear · Internal
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Forms
| Item | Amount | Price/Piece | Total | Description | |
|---|---|---|---|---|---|
| Solid/Gradient W/AR | $0.00 | ||||
| Solid W/O AR | $0.00 | ||||
| Gradient | $0.00 | ||||
| Polar W/AR | $0.00 | ||||
| Mirror/REVO | $0.00 | ||||
| Blue Light W/AR | $0.00 | ||||
| Lens + Lens Insertion drill mount frame w/solid or gradient lens |
$0.00 |
By signing below, I give Revival Vintage Eyewear permission to photograph and/or record me while I am participating in Revival Vintage Eyewear events, photoshoots, promotions, or other activities.
I understand that my photo, video, voice, image, and likeness may be used by Revival Vintage Eyewear for marketing and promotional purposes, including:
I understand that Revival Vintage Eyewear may edit, crop, reproduce, and combine photos or videos with other content and may use them without additional approval or compensation.
I voluntarily give Revival Vintage Eyewear permission to use my image, likeness, voice, and appearance for these purposes. I understand that I will not receive payment or other compensation for this use.
I am the parent or legal guardian of the participant named above and give Revival Vintage Eyewear permission to use their photo, video, voice, image, and likeness as described in this release.
I acknowledge that I requested a non-safety grade lens material, despite being advised against it by Revival Vintage Eyewear. I understand that this increases the risk of cracking, chipping, breakage, and other lens defects. I understand that safety-grade lens materials are recommended and I knowingly declined these materials.
By proceeding, I accept all risks and agree that Revival Vintage Eyewear is not responsible or liable for any lens-related failure, damages or personal injury resulting from lens breakage or material choice.
I've read and acknowledged the above.
Although we use the utmost care when handling our patients' own (previously worn or not) frames, a frame will occasionally break in the process. Frames may weaken or become over-stressed with use and over time. Therefore, Revival and our optical laboratories cannot be held responsible if breakage occurs during the handling process.
I agree that I have inspected and acknowledged the current status of my glasses. Noticeable dings, scratches, flaws are notated on this form. Photos of frames may also be taken prior to Revival working on them.
I've read and acknowledged the above.