I hereby authorize Vivo for Healthier Generations Society and its representatives to videograph/photograph or otherwise capture my photo, video, audio and written or verbal statements (collectively the "Recordings").
I understand that the Recordings may be used by Vivo for Healthier Generations and its representatives for marketing, public relations and promotional activities in perpetuity from the date consent is granted. I voluntarily give my consent and authorize Vivo for Healthier Generations and its representatives to use, reuse, distribute or publish the Recordings in any or all of its videos, publications, reports, documents, promotions, advertising, printed or electronic materials (collectively the "Materials"), including posting the Recordings on social media or online. I relinquish any and all personal or proprietary rights I may have in connection with such use. I understand that I will not receive any compensation should the Recordings be used.
I understand that I may revoke this consent at any time by contacting Vivo for Healthier Generations at 403-567-4464. If I revoke my consent, I agree that Vivo for Healthier Generations and its affiliates will not be required to destroy or stop using any Materials that have been or are currently being mass produced for circulation among the general public, prior to my revocation.
In consideration of my use of the services provided I hereby release and hold harmless Vivo for Healthier Generations, its affiliates, their agents, employees, officials representatives and contractors from any and all claims or liability or damages arising from the use, reuse, distribution or publication of the Recordings. I am over the age of 16 (sixteen) years.
IF THE PERSON IS UNDER THE AGE OF 16 (SIXTEEN), THE PARENT OR GUARDIAN OF SUCH PERSON SHALL AUTHORIZE THE FOLLOWING:
I, the undersigned, for good and valuable consideration the receipt and sufficiency of which is hereby acknowledged, hereby warrant that I am the parent or guardian of the minor(s) featured in the Recordings, having read and understood the contents of this document do hereby consent to those matters stated above and hereby irrevocably release and agree to indemnify Vivo for Healthier Generations and its affiliates from any and all liabilities of any kind in connection with the use of Recordings as contemplated above.
I have read and agree to the terms above.
Today's Date: May 18, 2021