COVID-19

^{Special Memorial Tribute to Victims and Families of COVID-19}

Special Memorial Tribute for Victims of COVID-19

If your family member was a victim of COVID-19 it’s important that you celebrate their life and legacy by registering for the Special Memorial Tribute (SMT). The Special Memorial Tribute will be simulcast via multiple forms of media conveying the significant loss of life due to this dreadful pandemic. The SMT will emphasize respect, admiration, empathy, togetherness, support, prayers and LOVE for victims across the world.

The Special Memorial Tribute is a scrolling visual of pictures and a brief biography of each COVID-19 victim. The SMT will allow the world to remember transitioned loved ones in a more positive light versus envisioning them transitioning alone in critical pain and despair. Families, friends and neighbors can gather and celebrate the beautiful life of their loved ones during this momentous event. You will be notified of the date and time of this Special Memorial Tribute.

Registration is simple. Upload your favorite pictures with a brief synopsis of the victim’s life journey. This information will be added to the data bank which will be used for the Special Memorial Tribute. Also, you have to sign a Permission Form allowing the company to access and use all submitted uploads.

A Keepsake Framed Certificate will be mailed for participating in the SMT. The Special Memorial Tribute is a vehicle for us to remember we are “One World United as One” facing this crisis together.

COVID-19 Tribute

Name of Loved One:

Date of Birth:

Date of Passing:

Contact Person:

Phone Number:

Alt. Phone:

Email:

Alt. Email:

Message:

Attachment

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I, the submitter of this form, grant permission to Family Derby hereinafter known as the "Media" to use my image (photographs and/or video) for use in Media publications including the following; Videos, Email Blasts, Recruiting Brochures, Newsletters, Magazines, General Publications, Website and/or Affiliates, and other media releases.

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I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive the right to royalties or other compensation arising from or related to the use of the image.

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By submitting this form, I acknowledge I am 20 years of age or older and am competent to contract in my own name or I am a legal guardian or parent of the person under the age of 20 and fully understand the contents, meaning and impact of this release.

NON-DISCLOSURES AND RESTRICTIONS

The following Family Derby LLC proposal contains information, which is privileged, confidential, and/or proprietary in nature. Such commercially sensitive information is not made available for public review. No license to or right of use for this commercially sensitive information is granted to any parties unless a written agreement exists between The Family Derby LLC and the entity and/or individual desiring to access or use the information. The information contained herein is submitted for purposes of review and consideration in connection with The Family Derby LLC's proposed event. No other use of the information and data contained herein is permitted without the express written permission of The Family Derby LLC.