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I hereby consent to interview(s), photography, audio recording, video recording and its/their release, publication, exhibition, or reproduction to be used for news, webcasts, promotional purposes, telecasts, advertising, inclusion on web sites, tweets or any other purpose by Clean Water Action or Clean Water Fund. I hereby release Clean Water Action and Clean Water Fund, together with their directors, officers, employees, agents, attorneys, volunteers, consultants, and consulting staff, from any liability connected with the taking, recording, digitizing, or publication of interviews, photographs, computer images, video and/or sound recordings. This does not waive any insurance policy held by Clean Water Action or Clean Water Fund.


I hereby waive all rights I may have to any claims for payment or royalties in connection with any exhibition, streaming, webcasting, televising, or other publication of these materials, regardless of the purpose or sponsoring of such exhibiting, broadcasting, webcasting, or other publication irrespective of whether a fee for admission or sponsorship is charged. I also waive any right to inspect or approve any photo, video, or audio recording taken by Clean Water Action or Clean Water Fund or the person or entity designated to do so by Clean Water Action or Clean Water Fund.

I hereby declare that I am at least eighteen (18) years of age and am legally competent to execute this release or that my parent or guardian set forth below has executed this release on my behalf. 

I acknowledge that I have fully informed myself of this consent, waiver of liability, and release. 

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