I, the undersigned, consent to the use, publication, and re-publication of any photograph, video, or interview provided by me or taken of me and/or my minor children by Catholic Community Services of Lane County or its agents for publicity and non-commercial advertising purposes.
I acknowledge and agree that Catholic Community Services of Lane County may rely on the release and waiver to use such photographs, video, and interviews without compensation to me. I waive the right to make any claim from using photos, video, and/or interviews including, but not limited to, claims of libel, slander, and invasion of privacy. This release shall benefit Catholic Community Services of Lane County, its successors, affiliates, and assigns.
I certify that the information provided is accurate and understand that my electronic signature below is my legal and binding signature.