By submitting your nomination you, hereby consent to the publication and use of my likeness (“Likeness”) for the purposes of promotion, publicity, advertising, and/or any other private or public purpose, without restriction, 1752 Club of Wisconsin, its members or affiliates. Likeness shall include, but not be limited to, photographs, sound and/or video recordings, films, broadcasts, brochures, publications, reports, web pages, promotional materials or any other audio-visual, electronic, printed, tangible work in any media or format, now known or hereafter to become known, and/or reproductions of any of these. I also grant permission to use my name, if desired, in connection with any said publication.
I acknowledge that I am executing this release voluntarily, and that my execution of this release is not required for my participation in any event or activity sponsored by 1752 Club of Wisconsin.
I acknowledge that neither I nor any third party will receive financial compensation for the use of my Likeness. I further agree that the actual material involved is and shall continue to be the property of 1752 Club of Wisconsin, and that neither I nor any third party shall have any right of review or approval regarding the use of my name and/or Likeness in such material.
I hereby release 1752 Club of Wisconsin, its contractors, members, officers, directors, legal heirs, agents, representatives, and assigns from any and all claims, demands, or causes of action arising out of the publication and use of my name and/or Likeness, in accordance with the terms of this release.
I understand that I may revoke my consent to this release at any time, and that upon receipt of my notice to revoke such consent, 1752 Club of Wisconsin shall only be obligated to refrain from creating any new materials that use my Likeness.
I hereby affirm that I have read this release prior to its execution and that I fully understand the contents thereof. This release shall be binding upon me and my heirs, legal representatives and assigns.