PromptCare Photo/Video Release

I hereby grant PromptCare Companies, Inc., and its parents, affiliates, representatives, employees, agents, and assigns (collectively, “PromptCare”) permission to create and use photographs, videos, and other digital reproductions of me or my physical likeness (referred to as a “Recording”) as described in this Release. I authorize PromptCare to utilize the Recording for publicity and marketing purposes regarding the services and products it provides and for other lawful purposes associated with in-home infusion, respiratory, nutritional, or home care, as well as for editorial, educational, and fundraising purposes.

I acknowledge that such Recording may be produced in any format, including video, print, electronic, or digital images, and may be published on PromptCare’s website, on social media pages, and in presentations, brochures/flyers, and newsletters.

I understand and agree that the Recording will become the sole property of PromptCare. I understand that I will not have the right to receive a copy, inspect, or approve any Recording prior to the uses authorized above. I further understand that this Release does not guarantee or require PromptCare’s use or publication of the Recording.

I understand that consenting to permit the creation and/or use of the Recording is of no direct benefit to me, and I waive the right to receive any royalties or other compensation arising or related to the Recording.

I hereby hold harmless, release, and forever discharge PromptCare from all claims, demands, and causes of action which, I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate may have related to this Release.

If applicable, I am the legal parent/guardian of the patient named below and am authorized to contract on behalf of the patient. I have read this Release before signing below and I fully understand the contents, meaning, and impact of this release.