UGC Terms

Video Consent and Release Form   

Without expectation of compensation or other remuneration, now or in the future, I hereby give my consent to Agile Meridian, LLC and Brandlens., its affiliates and agents, to use my image and likeness and/or any interview statements from me in its publications, advertising or other media activities (including the Internet).   

This consent includes, but is not limited to:   

(a) Permission to interview, film, photograph, tape, or otherwise make a video reproduction of me and/or record my voice;     

(b) Permission to use my name; and   

(c) Permission to use quotes from the interview(s) (or excerpts of such quotes), the film, photograph(s), tape(s) or reproduction(s) of me, and/or recording of my voice, in part or in whole, in its publications, in newspapers, magazines, and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for educational and awareness.   This consent is given in perpetuity, does not require prior approval by me, and takes effect as of the date of the media creation.