By submitting this information, I authorize Quila’s Angels Inc to use my personal information on this form and subsequent email and verbal conversations including but not limited to: (1) My name, (2) my picture – including photographic, picture, and electronic images, and (3) my story – including any personal information enclosed in the story.
By submitting the above information, you agree that the information provided is accurate and truthful.
I hereby grant to Quila’s Angels Inc, its officers, directors, employees, agents, subsidiaries, licensees, successors and assigns, the right to use, publish, and reproduce, for all purposes, my name, pictures, and stories provided by me in electronic and printed form described in sections above and all subsequent communications, verbal and electronic in any and all media including, without limitation, internet, exhibition, distribution, promotion, advertising, press conferences, meetings, hearings, educational conferences, and in brochures and other print media. This permission extends to all languages, media, formats and markets now known or hereafter devised. This permission shall continue forever unless I revoke such permission in writing Quila’s Angels Inc.
I further grant Quila’s Angels Inc all rights, title, and interest that I may have in all finished pictures, reproductions, and further grant Quila’s Angels Inc the right to give, transfer, and exhibit the print in copies or facsimiles thereof, for marketing, communications, or advertising purposes, as it deems fit.
I hereby waive the right to receive any payment or compensation for agreeing to this release and waive the right to receive payment or compensation for Quila’s Angels Inc use of any material described above for any of the purposes authorized by this release. I also waive any right to inspect or approve finished photographs, multimedia, or advertising copy or printed matter or computer generated scanned image and other electronic media that may be used in conjunction therewith or to approve the eventual use that it might be used in conjunction therewith or to approve the eventual use that it might be applied. Quila’s Angels Inc will edit my story if needed.
By submitting the form information to Quila’s Angels Inc, I acknowledge that I have read the foregoing and I fully understand the contents.