I consent and authorize to take photographs, video, or other visual images of me and/or my child and/or to record me and/ or my child’s voice, the results of which may be published into the public domain in print, visual, or electronic media including, but not limited to: brochures, direct mail, advertisements, newspapers, newsletters, magazines, television, radio, presentations, web sites, and trade show displays. I understand that the visual images or audio recordings may make my and/or my child’s identity recognizable.
I agree that all reproduction and all copyrights associated with the above-described media shall remain the property of The Little Medical School Corporation and its franchisees. I understand that the use of the communications efforts may directly or indirectly benefit the program financially. I agree that my child and/or I am not entitled and release any right to any claim my child and/or I may have related to the use of my and/or my child’s visual images and/or audio recordings, including but not limited to, any claim for payment or royalty in connection with distribution or publication of these communications.
I understand that I have the right to revoke this authorization in writing at any time by written request to The Little Medical School - Ottawa. But the revocation will not be effective to the extent that The Little Medical School already relied on my authorization; for example, the revocation will not apply to publications already in production nor will it apply to publications already distributed to the public. Otherwise, the authorization will remain in effect for 5 years or until the media utilizing the photograph(s) or interviews are no longer in use, whichever occurs later.
I understand that The Little Medical School will not condition my and/or my child’s participation on whether I sign this consent and authorization. I have read and understood the terms of this Consent. Clicking "I agree" evidences my voluntary consent and authorization for the publication of visual images and/or audio recordings of me and/or my child by The Little Medical School.