Image, Likeness, and Voice Recording Usage:

I grant permission to the rights to use my image, likeness, and sound of my voice as recorded on audio or video tape without payment or any other consideration to Peak Health Surgicare, LLC and my image, likeness, and recordings may be copied and distributed by various forms of media. I understand that my image may be edited, copied, exhibited, published, or distributed and I waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that my image, likeness, and recordings may be used for, including, but not limited to, research, education products, presentations, marketing, advertising, publication, and other educational resources may be used in diverse educational settings within an unrestricted geographic area.

I agree and acknowledge that I have read, understand, and agree to be legally bound by the terms of this release. I further agree and acknowledge that I am 18 years of age or older and that my signature below legally binds me to the terms of this release.