I hereby authorize Foot Relief Insoles LLC to:
(a) use my recorded video which contains my personal likeness, photo,
and voice on video, audio, photographic, digital, electronic, online format
or on any and all other media. (b) Use my name in connection with this
recording if my name was included in the recording. (c) Use, reproduce,
publish, republish, exhibit, edit, modify, or distribute, in whole or in
part, this recording in all media without any additional compensation granted
other than one free pair of Foot Relief Insoles Brand Insoles, for any
purpose that Foot Relief Insoles LLC deem appropriate, including promotional
or advertising efforts. This recording may appear in a variety of formats
and media that are now available to Foot Relief Insoles LLC and that may
be available in the future (e.g. print publications, video tapes, CD-ROM,
Internet, mobile, digital). I hereby release Foot Relief Insoles LLC from
liability, claims, compensation claims, and demands for any violation of
any personal or proprietary right I may have in connection with such use,
including any and all claims for libel, defamation, or invasion of privacy.
I understand that all such recordings, in whatever medium, uploaded through
this web form are time stamped and include the IP address of the party
submitting this form, and are verifiable and directly linked to the person
submitting this form by name, address, telephone, digital signature, and
order number and that all recordings submitted through this web form shall
remain the property of Foot Relief Insoles LLC unless I submit in writing
a request to Foot Relief Insoles LLC to remove my recordings and pay the
retail price for the free insoles I received. I have read and fully understand
the terms of this release.