Photo Release & Consent

I, do hereby give to 1199SEIU United Healthcare Workers East, their successors and assigns, my permission to use pictures made of me and comments made by me on this date in video tapes, printed material, digital media, advertisements, and any other materials without payment to me for such use. I will make no monetary or other claim against 1199SEIU United Healthcare Workers East for the use of the pictures and/or comments. I further agree to indemnify and hold harmless 1199SEIU United Healthcare Workers East, their successors and assigns, from and against any and all liability that might arise out of any use or publication of said comments and pictures.