I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or
video tape without payment or any other consideration. I understand that my image may be edited, copied,
exhibited, published or distributed. I waive the right to inspect or approve the finished product wherein my
likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the
use of my image or recording. I also understand that this material may be used in diverse educational settings
within an unrestricted geographic area.
Photographic, audio or video recordings may be used for the following purposes:
- Conference presentations
- Educational presentations or courses
- Informational presentations
- On-line educational courses
- Educational videos
By signing this release, I understand this permission signifies that photographic or video recordings of me may
be electronically displayed via the Internet or in the public educational setting.
I will be consulted about any use of the photographs or video recording for any purpose other than those
There is no time limit on the validity of release nor is there any geographic limitation on where these materials
may be distributed.
This release applies to photographic, audio or video recordings collected as part of the sessions listed on this
By signing this form, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release all claims against any person or organization utilizing this
material for educational purposes.