Video Consent and Release Form
Without expectation of further compensation or other remuneration, I hereby freely give my consent to CoverAlls Decals, to use my image and likeness and/or any interview statements to be used in its publications, advertising and/or social media activities.
This consent is given exclusively in the promotion and/or marketing of CoverAlls Decals in perpetuity, without prior approval by me.
This consent includes:
(a) Permission to use part or the entirety of this video in an interview, film, photograph, tape, or other video reproduction of me and/or record my voice;
(b) Permission to use my name; and
(c) Permission to use quotes (or excerpts of such quotes) from the video, interview, the film, photograph(s), tape(s) or reproduction(s) of me, and/or the recording of my voice in its publications, in newspapers, magazines and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for educational and awareness.
This consent takes effect as of the date of the media creation.