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2. First Name
3. Last Name
5. Address1
7. Address2
9. City
10. State
11. Zip
13. Email Address
15. Describe the photos you are submitting
17. Release
    I hereby grant permission to the City of Bristol to use the attached photos for use on the City of Bristol, Connecticut website. This authorization is continuous and may only be withdrawn by my specific rescission of this authorization.
19. Upload Photos
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20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

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