Authorization and Release Agreement
By checking the box above, I indicate my agreement with the terms and conditions of this Authorization and Release with the American Heart Association, its officers, directors, employees, contractors, agents, volunteers and representatives (collectively "AHA"). I agree to provide the AHA with my name, a photo of myself, and information in answering the questions provided above. I hereby grant to the AHA the right to use my name, the photo, and my information, in any way it chooses, including but not limited to the right to broadcast, exhibit, and publish my name, photo, and my information. I confirm that I have the right to enter into this Agreement, that I am not restricted by any other commitment and that the AHA has no financial commitment or obligation to me as a result of this Agreement. Further, I expressly release and indemnify the AHA from any and all claims known and unknown arising out of or in any way connected with the above granted uses and representations. The rights granted the AHA herein are perpetual and worldwide.