Multimedia and Testimonial Authorization and Release Form:

By signing this form, I grant Salus Medical Training, LLC as well as its parent, subsidiary, successor (s) in interest, vendors, or other third party working on its behalf (collectively the "additional parties"), the right to use photographs, digital images, and video provided by me or recorded of me by Salus Medical Training, LLC or its vendors, along with audio, verbal, and written statements or testimonials made by me in any and all media now or hereafter for illustration, editorial, or promotional purposes, and to include my name (and my child's, if applicable) in connection therewith. Additionally, I am not making nor will I make any monetary demand against Salus Medical Training, LLC, or any of the additional parties for the use of my name, likeness, media, testimonial, or statement covered by this Authorization and Release.

I hereby release, hold harmless, and discharge Salus Medical Training, LLC and the additional parties from any and all claims, causes of action, damages, injury, or any demands arising our of or in connection with the use of multimedia, statements or testimonials as listed above.

I am 18 years of age or older* and have the right to authorize the use of my name and/or that of my child as applicable. I have read the information above, fully understand the contents of this form, and am hereby freely and voluntarily executing this Authorization and Release.