Claim Form – Baxter Springs – Worth a thousand words…

National Disaster Photo Rescue Claim Form - Baxter Springs

To claim photos from The Lost Photos of Baxter Springs Project, please fill out this form as much as possible. The more information provided, the easier it is for us to get you connected back to your photos. If you are missing any photos that are not shown on our website, please let us know the description of those as well.

Photo Reference Numbers*
The photo reference numbers are written on each photo. Example: 001-001-001. They indicate where the photo is stored. Without this number we probably can't locate your photo. Also, please include a description of the photo, such as child or adult, hair color, setting, etc.
How do you want to be contacted?*
- Email (be sure to include your email address)
- Phone (please leave the best number to reach you at)
- I will just see you at the next photo event.
Preferred Method of Returning Your Photos to You
- US Mail (please include your mailing address)
- In person at Carthage First Baptist Church
- In person at Photo Reunification Event
Name*
First Last
Current Address*
Street Address Address Line 2 City State ZIP Code
Daytime Phone*
Evening Phone*
Email (recommended)
Address Photos Lost From
Future Contact Information:
- Yes, contact me about future media interviews.
- No, please do not contact me.
Acceptance*
- The undersigned authorizes The Lost Photos of Baxter Springs Project and National Disaster Photo Rescue the use and display of said photographs/images in any publication, multimedia display, advertisements or internet publications.
- The undersigned releases and forever discharges The Lost Photos of Baxter Springs Project and National Disaster Photo Rescue, its agents, officers and volunteers from any and all claims and demands arising out of or in connection with the use of said photographs/images, including but not limited to, any claims for invasion of privacy or defamation.
- The undersigned attests that the claimed items are the personal property of the undersigned.
- Accepted and agreed:
Signature*
Please type name to sign form.
Date
Additional Information
Is there anything else we need to know that we have not asked?