Racks to Riches Interview Release Form 

I  hereby grant permission for Racks to Riches, LLC and/or any person(s) or entities authorized on Racks to Riches behalf to record, tape, film, photograph, digitize, or otherwise capture and preserve in permanent form my name, likeness, biographical material, voice, and/or performance/display (hereinafter “Recording”).

I grant permission for Racks to Riches, LLC to make copies in any form or media of the Recording made of me and described above, including digitized copies or written transcriptions. I further grant permission for Racks to Riches or any person or entity authorized by it, to edit or alter the Recording (hereinafter “Altered Recording”) and to digitize, distribute, broadcast, publish, or transmit all or any portion of the Recording or the Altered Recording, in any form, via any means, in perpetuity, throughout the world.

I also release Racks to Riches, LLC, and its officers, agents, faculty, and employees, including any person(s) or entities authorized by Racks to Riches, LLC, from any and all claims based on my performance or display in this Recording as defined in paragraph one or based on any use of my performance or display.

I certify that I am 18 years or older, and have read this release and consent form and understand all its terms: