CARES Foundation


Emergency Experience Stories
Please type your story here:
First Name: *
Last Name: *
Email Address: *
Please select one: *	List me by first name, last initial I would like to remain anonymous in my submission
Digital Release of Story
I hereby grant CARES Foundation, Inc. permission to use my name, story, and likeness in a photograph or videotape in any and all of its publications, website, or other outlets, without payment or any other consideration.
I understand and agree that these materials will become the property of CARES Foundation, Inc. and will not be returned.
I hereby irrevocably authorize CARES Foundation, Inc. to edit, alter, copy, exhibit, publish or distribute this photo or videotape for purposes of publicizing CARES Foundation, Inc.’s programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph or videotape.
I hereby hold harmless and release and forever discharge CARES Foundation, Inc. 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 am 21 years of age and am competent to contract in my own name. I have read this release before signing below and I fully understand the contents, meaning, and impact of this release.
Check before completing: *	I have read & acknowledged the above digital release, allowing for this submission to be shared with providers and legislatures at the discretion of CARES Foundation.

Timeout Warning

Emergency Experience Stories

Digital Release of Story