NOTE: For anyone under 18 years of age, this form must be signed by the Parent / Guardian.
By signing this form, I consent to the following:
I consent to the use and disclosure of media containing my information or likeness in it. This includes, but is not limited to:
* Images
* Quotes
* Name
* Participation in interviews
* Photographs
* Recordings
* Videos
I give this consent to The Health Pals Company, LLC (hereby denoted as "Company") and any members of the press Company may invite. This consent includes for sponsored events held by Company.
I grant Company and invited members of the press the right to disclose, edit, use, and reuse the media. This includes use in print, on broadcasts, in online spaces (such as the Company
website(s) and social media accounts and those of the press), and all other forms of media.
I understand that when the Company hosts a public event, individuals at the event may take their own
photographs, videos and audio of the event, that such recordings may capture me, and that they may also be made public. I also release the Company, its agents, and employees from all claims, demands, and liabilities in connection with the rights granted above.
By signing this form, I attest that I am the person, named below.