"*" indicates required fields This release is to be signed by all people whose stories and/or images TECHNOLOGY FOR LIVING proposes to use in our publication, online videos, social media or any other media. I do for myself, my heirs, executors, administrators, predecessors, successors, agents and assigns, does hereby grant, release and forever discharge and agree to save harmless the TECHNOLOGY FOR LIVING, its officers, directors, employees, agents, servants, predecessors, successors, assigns, and related or associated companies, the authority, permission, and agreement: a) the unrestricted right and permission to use, re-use, publish and republish, my name, information about me (including and not limited to my disability, medical treatment and care), my relationship to TECHNOLOGY FOR LIVING, photographic portraits, pictures, audios, videos, or images of me without restriction as to changes or transformations in conjunction with articles which may or may not contain my direct phrases and quotes, or reproduction hereof in colour or otherwise, made through any and all media now or hereafter known for illustration, education, promotion, fundraising, advertising, reporting, or any other purpose whatsoever. b) in the event that TECHNOLOGY FOR LIVING is unable to contact me, I hereby relinquish my right to examine or approve the completed product or products or printed matter or image for publication for distribution by any means or media including the internet without restrictions. c) I hereby release, discharge, and agree to save harmless TECHNOLOGY FOR LIVING, from any fee, royalty, or liability associated with the use of my image or article of and about me including without limitation any claims for libel or invasion of privacy. I have read the above authorization, release and agreement, prior to its execution; I fully understand the contents thereof. This consent is valid until TECHNOLOGY FOR LIVING receives written notification revoking this release. Full Name* Phone*Email* Address* Street Address City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Upload File(s) Drop files here or Select files Max. file size: 100 MB. Name of Parent or Legal GuardianIf this release is obtained from a presenter under the age of 19 or a person with disabilities unable to sign, then the name of that presenter’s parent or legal guardian/representative is also required. Aggreement* I agree and understand that TFL accepts no obligations or financial responsibilities if a photograph is used.CAPTCHANameThis field is for validation purposes and should be left unchanged.
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