I hereby authorize Fortitude Careers to:

(1) Record my image, likeness, and/or voice on a photographic, video, audio, digital, electronic, or any other medium;

(2) Use, reproduce, modify, exhibit and/or distribute any such recording, in whole or in part, in any manner or medium now known or hereafter developed (including without limitation, print publications, DVDs, internet) for any purpose that Fortitude may deem appropriate, including without limitation promotional or advertising efforts; and

(3) Use my name and biographical material in connection with any such recordings or uses.

I hereby understand that:

  1. There shall be no payment for this release
  2. No royalty, fee or other compensation shall become payable to me by reason of such use.

I hereby waive the right to inspect or approve any such recordings and uses. I understand that Fortitude will be the owner of all such recordings and uses.

I hereby release and hold harmless Fortitude from liability for any violation of any personal or proprietary right I may have in connection with all such recordings and uses.

I have read and fully understand the terms of this consent and release.

Signature: __________________________________________

Printed Name: ______________________________

Address:  __________________________________

_________________________________________

Phone: ____________________________________

Date: _____________________________________

Term Dates: ______________

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