Image release

Last reviewed: January 29, 2024

I, the Subject identified below, irrevocably grant the right and my permission to Welia Health (“Company”), its parents, subsidiaries, affiliates, successors, assigns, licensees, employees and agents and those acting on Company’s behalf to interview, record, publish, reproduce, photograph, film and/or use my photo, image, name, likeness, voice, performance and/or my personal information, including my city of residence (collectively, “Materials”) for advertising, promotional, and other commercial purposes. This may include use of my information in one or more of the following mediums: radio, television, newspaper and/or shopper news article, press release, public service announcement, advertisement or flyer; newsletter; web page; brochure; poster; direct mail; tradeshow exhibits; photo exhibit; slides; video/audio tape; presentations; tours; television; training aids; all social media; and other materials that may not be listed (each a “Program”). I understand that I have no rights to the Program or any benefits or income derived therefrom. I hereby irrevocably waive all legal and equitable rights relating to all liabilities, claims, demands, damages, or expenses arising directly or indirectly from Company’s exercise of its rights under this agreement or exploitation of the Materials or the Program. I agree that the Program, as between me and Company, is solely and exclusively owned by Company and may be edited as desired and distributed, exhibited, exploited, promoted, and used in whole, or in part, in any form, format, manner or media, either now known or hereafter created, worldwide in perpetuity.

I represent and warrant that I have the right to grant the permissions and licenses herein, and to enter into this agreement, and that my performance and the rights I have granted herein will not conflict with or violate any commitment or understanding I have with any other person or entity, nor be defamatory or infringe upon any rights (including without limitation privacy rights) of any person or entity.

I agree to indemnify and hold harmless Company its affiliates, licensees, directors, employees, agents, and service providers from and against any and all claims, losses, expenses, and liabilities of every kind, including attorneys’ fees, arising out of the inaccuracy or breach of any representation, warranty or undertaking I have made in this agreement and any and all claims arising out of the use of the Program. I understand that nothing herein requires the Company to use my appearance in or in connection with the Program.

If the Subject is a minor, I, the undersigned, represent and warrant that (a) I am the parent or legal guardian of the Subject, (b) I have the legal right, power, and authority to consent to this agreement on behalf of the Subject and myself, and (c) I am at least 18 years of age. I have read, and I understand, this entire agreement. By signing below, I hereby consent to and approve in all respects the terms and conditions of this agreement and agree that both the Subject and I shall be bound by all of its terms and conditions. I understand that this consent and approval is not revocable.

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By providing my information and clicking “Submit,” I hereby consent to the terms of this release.