I hereby grant Circle City Midwifery & Women's Health Services Inc, its representatives, and employees permission to use and/or publish photographs or videos of myself in print and/or electronically. I understand and agree that these materials will become the property of Circle City Midwifery & Women's Health Services Inc and will not be returned. I hereby authorize Circle City Midwifery & Women's Health Services Inc to edit, alter, copy, exhibit, publish, or distribute the photograph or video for purposes of publicizing their services or for any other lawful purpose. In addition, I waive my rights to any compensation arising or related to the use of the photographs or videos. I release and discharge Circle City Midwifery & Women's Health Services Inc from any and all claims arising out of the use of the photos or videos for any lawful purpose such as for publicity, illustration, advertising, and Web content.
Additionally, I grant Circle City Midwifery & Women's Health Services Inc, and its agents and employees, the irrevocable and unrestricted right to reproduce the photographs and/or video images taken by me, or members of my family, for the use of publication, promotion, illustration, advertising, or trade, in any manner or in any medium. I hereby release Circle City Midwifery & Women's Health Services Inc and its legal representatives for all claims and liability relating to said images or video. Furthermore, I grant permission to use my statements that were given during this submission, with or without my name, for the purpose of advertising and publicity without restriction. I waive my right to any compensation.
In the case of minors, Circle City Midwifery & Women's Health Services Inc has my permission to use photos or video of my child or legal custody with all the permissions outlined above. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.
