I hereby authorize Community Medical Centers, its employees, agents, and designees to take photographs, electronic images, and audio/video recordings of me (hereinafter referred to as “Photographs”). I understand that Community Medical Centers intends to use these Photographs for internal and/or external education, marketing, fund raising, and/or other similar purpose in support of Community Medical Centers’ goals.
I hereby acknowledge that these Photographs belong to Community Medical Centers, and I consent to the Photographs being published, exhibited, reproduced, copied and/or otherwise used or disclosed by Community Medical Centers. I further consent to the use of my name and identity in the descriptive text or commentary in connection with the Photographs. I understand that I will not receive payment or any other compensation in connection with these images.
I release Community Medical Centers, its employees, agents, and designees from any and all liability which may or could arise from the taking, recording, publishing, distributing, or other use of the Photographs.
I understand that my work with Community Medical Centers is not conditioned upon my execution of this Consent. I understand that I may refuse to execute this Consent without any consequence to my status at Community Medical Centers.