Without an expectation of compensation or other remuneration, now or in the future, I hereby give my consent to StuchyCreative, its affiliates and agents, to use my image and likeness and/or any interview statements from me in its publications, advertising or other media activities (including the Internet).

This consent includes, but is not limited to:

a)Permission to interview, film, photograph, tape, or otherwise make a video reproduction of me and/or record my voice

b)Permission to use my name

c)Permission to use quotes from the interview(s) (or excerpts of such quotes), the film, photograph(s), tape(s) or reproduction(s) of me, and/or recording of my voice, in part or in whole, in its publications, in newspapers, magazines and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for educational and awareness.

This grant includes without limitation the right to edit, mix or duplicate, and to use or re-use the Product in whole or in part as Company may elect.  Company or its designee shall have complete ownership of the Product in which I appear, including copyright interest, and I acknowledge that I have no interest or ownership in the Product or its copyright.

This consent is given in perpetuity and does not require prior approval by me.