Release for the Use and Disclosure of Images, Voice and/or Written Testimonials

Including Vail Health Foundation, Vail Health Behavioral Health, Colorado Mountain Medical, Howard Head Sports Medicine, and Shaw Cancer Center.

Date:

I, (enter your full name)

Name:

give Vail Health and its authorized agents permission to record my testimonial, image and/or voice and grant Vail Health all rights to use these testimonials, recordings, or photographs, including those I have provided, in any format or medium for educational, promotional, advertising, or other purposes that support Vail Health's mission.

I understand that I am a volunteer and that I will not be compensated or paid for granting Vail Health the right to use my testimonials, images and/or voice.

I waive all claims I may have against Vail Health and its authorized agents relating to this release and my testimonial, images and/or voice.

I understand that I am performing my duties during this interview or video/photo shoot within the scope of my employment.

Signature:

In place of your signature, you may type your full legal name here:

Job Title:

Department:

E-mail:

Telephone:

Address:

Employee Release Form

Release for the Use and Disclosure of Images, Voice and/or Written Testimonials