Authorization and Release Information

I understand my media uploaded and made on behalf of PASCO (hereinafter called “The Company”) may be used in connection with publicizing and promoting The Company. I authorize The Company to use my name, photo, biographical information, and the submitted story as defined on this form.

I hereby irrevocably authorize The Company to copy, exhibit, publish or distribute the Story for purposes of publicizing The Company’s programs or for any other lawful purpose. These statements may be used in printed publications, multimedia presentations, on websites, or in any other distribution media. I agree that I will make no monetary or other claims against The Company for the use of the statement.

I hereby hold harmless and release The Company 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 have or may have by reason of this authorization.

I have read the authorization and release information and give my consent for the use as indicated above.