I, Full Name* grant consent, herein known as Media release consent, to use my image/video in media publications including:
I, the undersigned, hereby consent to the use of my photograph or electronic matter that may be used in conjunction with them now, or in the future in media, video, brochure, pamphlet or promotion furthering the mission of Women That Give(WTG). By signing this Consent, I understand I am releasing Women That Give from any and all liability that may occur as a direct or indirect result of my picture, video or the release of the public relations materials, including but not limited to the use of any quotations.I have read the above release and waiver, and fully understand its contents. I voluntarily agree to the terms and conditions stated above.