Media Release Form

I hereby grant The MindReset permission to photograph, film, and/or record on film, tape, or otherwise, my image, likeness, and/or voice for their use. I hereby release and waive to The MindReset any and all rights and privileges, including without limitation the rights of privacy and publicity, that I may have in or arising out of my participation in this event, and waive any right that I may have to inspect or approve the finished products or the use of which they may be applied.

I agree The MindReset may use such photographs and/or films of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

I am of full age and have the right to contract in my own name. I have read the foregoing and fully understand the contents thereof. This release shall be binding upon me and my heirs, legal representatives, and assigns.

By checking the box in the form where this Media Release Form is located, I understand the terms of this agreement.

Print-Sign-Scan TMR Media Release Form