I, ______________, grants permission to Mothers Against Drunk Driving Central Valley, to use my media (photograph image and/or video footage and/or audio recordings).
I likewise understand that I may be identifiable from the reproduction of the media by Mothers Against Drunk Driving Central Valley indicated herein this agreement.
I hereby waive my rights to inspect or approve the media for production that may be used by Mothers Against Drunk Driving Central Valley for purposes stated herein, from hereon forward.
I likewise waive any right to royalties or any compensation arising from or related to the use of the image.