I hereby authorize [Your Company Name], hereafter referred to as “Company,” to publish photographs taken of me, and my name and likeness, for use in print, online and video-based marketing materials, as well as other Company publications during my employment.

I hereby release and hold harmless Company from any reasonable expectation of privacy or confidentiality associated with the images specified above.

I acknowledge that my participation is voluntary and that I will not receive financial compensation of any type associated with the taking or publication of these photographs or participation in company marketing materials or other Company publications.  

I acknowledge and agree that publication of said photos confers no rights of ownership or royalties whatsoever.

I hereby release Company, its contractors, its employees, and any third parties involved in the creation or publication of marketing materials, from liability for any claims by me or any third-party connection with my participation.

I further understand that I have the right to provide written notice to Company or its representative to withdraw my consent.  Company has 10 days to remove my consent.

 Agreed and Accepted:

 Printed Name: ___________________________________________________

 Signature: _________________________   Date: _______________________