Photo and video release form

Please read the information below then check the box if you are in agreement. 

I hereby grant to Beacon Mobility or any subsidiary thereof, permission to use my likeness in a photograph in any and all of its publications, including but not limited to video, printed and digital publications, and social media. I understand and agree that any photograph using my likeness will become the property of Beacon Mobility and its subsidiaries and will not be returned. I acknowledge that since my participation with Beacon Mobility and its subsidiaries is voluntary, I will receive no financial compensation. I hereby hold harmless and release and forever discharge Beacon Mobility and its subsidiaries from all claims demands and causes of action which I, my heirs, representatives, executors administrators, and any other persons acting on my behalf, or behalf of my estate have, or may have by reason of this authorization. I hereby irrevocably authorize Beacon Mobility and its subsidiaries to edit, alter copy, exhibit, publish, or distribute this photo for purposes of publicizing Beacon Mobility and its subsidiaries, business lines, or programs, or for any other related lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written, or electronic copy, we are in my likeness appears. Additionally, I waive any right to royalties, or other compensation arising out of or related to the use of the photograph.