Consent to Photograph /Videotape / Interview Individuals Please read, date and provide your signature on the next pages Terms & Conditions I hereby agree and give my permission for BIPOC + Local and/or partners to record, film,photograph, videotape myself (hereinafter collectively referred to as “Works”) and to display, publish or distribute these Works for the purpose of publishing, posting on the BIPOC + Local website and posting on social media sites. I hereby waive any right to approve the use of these Works now or in the future, whether the use is known to me or unknown, and I waive any right to any royalties related to the use of these Works. I understand that the Works may appear in electronic form on the internet or in other publications outside of the BIPOC + Locals control.