I grant permission to COMPANY and its agents or employees to use photographs and/or video and audio taken of me.  These images may be used in educational, documentary and commercial materials such as Public Service Announcements, Grant Applications, Video Documentaries, Commercial Television and both printed and online newsletters and newspapers.  Furthermore, I authorize the use of my image, likeness, and voice for all program promotion, materials, and any other purposes in connection with the program deemed appropriate and necessary by THE COMPANY.

I hereby agree to release, defend, and hold harmless COMPANY and its agents or employees, including any firm publishing and/or distributing the finished product in whole or in part, whether on paper, via electronic media, or on Web sites, from any claim, damages, or liability arising from or related to the use of the photographs/video, including but not limited to any misuse, distortion, blurring, alteration, optical illusion, or use in composite form, either intentionally or otherwise, that may occur or be produced in taking, processing, reduction, or production of the finished product, its publication, or distribution.

I am 18 years of age or older and have read this release before signing below, fully understanding the contents, meaning, and impact of this release.  I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

I Consent to Receive SMS communication. Message & data rates may apply. You can reply STOP to unsubscribe at any time.