I hereby authorize Lifeline Children’s Services, Inc. and its affiliates, successors and assigns, (hereinafter referred to as “Lifeline”), and EB Photography to use, publish and reproduce, whether in print, video or digital format, photographs or videos that have been taken of me and/or my minor child(ren) listed below, including photographs or videos provided to Lifeline by me or my spouse, for marketing or educational purposes, including their use in any Lifeline print or electronic publications.

I release Lifeline and EB Photography from any expectation of confidentiality for the below listed minor child(ren) and myself related to the use of the above-mentioned photographs and videos, and attest that I am the parent or legal guardian of the child(ren) listed below and that I have the authority to authorize Lifeline to use their physical image(s).

I acknowledge that since authorizing the use of photographs or videos of me and/or my minor child(ren) is voluntary, neither the minor child(ren) nor I will receive financial compensation.

I further agree that authorizing the use of photographs and videos of me and/or my minor child(ren) in any publication and/or website produced by Lifeline confers no rights of ownership whatsoever.

I hereby fully and forever release and discharge Lifeline Children’s Services, Inc. and EB Photography, its officers, employees, representatives, agents, affiliates, successors, and assigns from any and all liability, obligation or responsibility for any damage, injury, liability or loss of any nature whatsoever suffered or incurred by any person as a result of the release and use of the above-mentioned photographs and videos.