I hereby authorize and give my full consent to Bridging Bionics Foundation (BBF), and any other designated person, to capture images and/or recordings of myself, and I consent to copyright and/or publish any and all photographs, videotapes and/or film in which I appear while participating or attending BBF programs, related events or activities. I understand that BBF shall be entitled but not obliged to use my Contribution and to edit and alter my Contribution at its discretion. I further agree that BBF may without my further consent, transfer, use or cause to be used my Contribution, name, likeness, biography, these photographs, videotapes, or films for any exhibitions, public displays, publications, commercials, art and advertising purposes, and television programs without limitations or reservations in all media worldwide.
I confirm that my Contribution is original, in all respects true, shall not infringe the rights of any third party, and is not defamatory, blasphemous or obscene or calculated to bring BBF into disrepute
Contributor (Print Name):
Signed: Clear
Date:
Address:
Where the Contributor detailed above is under 18 years of age, I confirm that I am the parent/guardian of the Contributor and my acceptance of the above on behalf of the Contributor:
Parent/Guardian (Print Name):
