New Release "*" indicates required fields I consent to and authorize Children’s Cancer Research Fund (“CCRF”) to use my name, voice and likeness, along with any quotes, photographs, comments, stories, videos, testimonials, whether written, recorded or oral (individually or collectively, the "Content"), in whole or in part, in connection with any materials produced by, or on behalf of, CCRF (“Advertising Materials”). CCRF shall have the perpetual, unrestricted and unlimited right to use the Content in any and all media now or hereafter known throughout the world without any further compensation to me. CCRF shall also have the right to edit, modify and alter the Content as it deems necessary in its sole discretion, as long as such modification does not change the basic nature of the Content. I agree that no Content or Advertising Materials need be submitted to me for approval and that CCRF is not obligated to make any use of the rights set forth herein. I agree that any testimonial provided by me is true and accurate and reflects my honest beliefs and real experiences. I expressly release CCRF and its officers, employees, agents and designees from any and all claims, known and unknown, arising out of or in any way connected with this Agreement. In no event shall CCRF be liable to me in connection with the Advertising Materials for any direct, indirect, incidental, consequential, special, punitive or exemplary damages. This Agreement shall be binding upon my survivors, heirs, descendants, administrators, executors and all others who have or may have a legal claim or rights by virtue of my agreeing to the above terms. For minors: I, the undersigned hereby state that I am the parent or legal guardian of the child and do hereby consent and give my permission to this Agreement. I have read the above authorization, release and agreement and am fully aware of all that it states or implies. Name (or Parent or Guardian Name)* First Last Child's Name* First Last Address* Street Address City State / Province / Region ZIP / Postal Code Phone*Date* MM slash DD slash YYYY Signature*EmailThis field is for validation purposes and should be left unchanged.