Image/Video Consent Form

I hereby grant and authorize The Transition House. Inc. and Inspire Counseling & Support Center, the right to take, alter, edit, copy, exhibit, publish, distribute and make use of any and all photos or pictures or videos taken of me to be used in and/or for legally promotional materials including but not limited to: newsletters, flyers, posters, brochures, advertisements, fundraising letters, annual reports, press kits and submission to journalists, websites, social networking sites and other print or digital communications without payment or any other considerations. This authorization extends to all languages, media, formats and markets now known or hereafter devised. This authorization shall continue indefinitely unless I otherwise revoke said authorization in writing. I understand and agree that these materials shall become the property of The Transition House, Inc and Inspire Counseling & Support Center and will not be returned. I hereby hold harmless, and release The Transition House Inc. and Inspire Counseling & Support Center from all liability petitions, and cause of action which I, my heirs, representative, executors, administrators or an other person may make while acting on my behalf or on behalf of my estate.