Photographic, Video, and Audio Consent and Release Form

I understand that photographs, video and audio will be taken and recorded of me during this networking event. I hereby grant Leadership Mission International the right to use any verbal or written statement, film and/or photograph(s) resulting from the event in any publicity materials, websites, books, television, newspapers and magazine articles at the sole discretion of Leadership Mission International as it relates to promoting awareness campaigns for the cause of reducing supporting our mission to empower women leaders in Honduras.

I further consent that my name and identity, school and city or county of residence may be revealed by descriptive text or commentary. Neither individual addresses nor telephone numbers will be published within these materials.

I do hereby grant Leadership Mission International the right to exhibit any such works publicly or privately, including posting on the LMI website. I waive any right, claims or interest I may have to control the use of my identity or likeness in the photographs, video or audio and agree that any uses described herein may be made without compensation or additional consideration to me.

I represent that I have read and understand the foregoing statement and I am competent to execute this agreement.