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 Hispanic Image Smart Women Biz Hub and/or partners to record, film, photograph, audiotape, or videotape myself (hereinafter collectively referred to as “Works”) and to display, publish, or distribute these Works for the purpose of publishing, posting on the Rise Asset Development 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 Hispanic Image's control. I agree that I will not hold Hispanic Image Smart Women Biz Hub responsible for any harm that may arise from such unauthorized reproduction.

Upon submission, this application will be looked over by the board of directors. Submitting this form does not mean you are automatically approved. An email will be sent to you within 72 hours of submission with the final decision. If not approved, you will be refunded. By submitting this document, you are agreeing that your business is up to date with the following licenses and certifications and that it is following the laws and policies of the state of Massachusetts.