PART 4: DECLARATION
We hereby declare that the facts and accompanying information stated in this NOMINATION FORM FOR CHAMPION OF RESILIENCE - INDIVIDUAL/TEAM CATEGORY, are true, correct and verifiable, to the best of our knowledge, and satisfy the eligibility criteria of the VIRTUS AWARDS.
If this nomination makes it into the SHORTLISTING of candidates for further evaluation, we consent to submit additional information which the HSMA Organizers and Judges may require. We understand that the information will be used by the Organizers and Judges in evaluating the Final Awardees and we consent to the use of such information for that purpose.
Finally, if selected as a Finalist or Award Recipient, we hereby authorize the release and use, in connection with the VIRTUS AWARDS for 2020 and henceforth, of our names, our Property’s Name, non-financial information, photographs, video and audio recordings of us in any form of media and from whatever source.