For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, I, the undersigned, authorize InnovatorMD (“Producer”)  and their respective parents, affiliates, subsidiaries, licensees, successors and assigns to make use of my appearance in the Meeting (the “Program”).

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I agree that the Producer may tape, videotape and photograph me, and record my voice, conversation and sounds, during and in connection with my appearance and that you shall be the exclusive owner of the results and proceeds of such taping, photography and recordings with the right, throughout the universe, an unlimited number of times in perpetuity, to copyright, use, reuse, modify, and to license others to use, in any manner, all or any portion of such recordings or a reproduction thereof, in connection with the Program, any derivative works based upon the Program, and in connection with Producer, Videographer or otherwise.

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I hereby release and discharge the producer from any and all claims and demands arising out of or in connection with the use of the images and my name, likeness, and identity, including without limitation any and all claims for libel, privacy, or publicity.

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I further represent that any statements made by me during my appearance are true, to the best of my knowledge, and that neither they nor my appearance will violate or infringe upon the rights of any third party.

** You can withdraw this permission anytime by sending us an email at info@innovatormd.com