Instructions

Every family member age 18 and up must sign the release form. If you are signing for a minor (under 18) please indicate that in the Parent/Guardian consent.

Grant

For consideration which I acknowledge, I irrevocably grant to B the Difference and B the Difference’s assigns, licensees, and successors the right to use my image, name, and information from the B Kind Questionnaire in all forms and media including composite or modified representations for all purposes, including advertising, trade, or any commercial purpose throughout the world and in perpetuity. I waive the right to inspect or approve versions of my image used for publication or the written copy that may be used in connection with the images.

Release

I release B the Difference and B the Difference’s assigns, licensees, and successors from any claims that may arise regarding the use of my image, including any claims of defamation, invasion of privacy, or infringement of moral rights, rights of publicity, or copyright. B the Difference is permitted, although not obligated, to include my name as a credit in connection with the image.

B the Difference is not obligated to utilize any of the rights granted in this Agreement.
I have read and understood this agreement and I am over the age of 18. This Agreement expresses the complete understanding of the parties.