Conscious Capitalism, Inc.
Media Release

For consideration received, which I acknowledge, I hereby grant to Conscious Capitalism, Inc., its agents, their successors and assigns, and those acting under their permission, or upon their authority, or those whom they are commissioned for, Conscious Capitalism, Inc. the right and permission to:

1) Reproduce, copyright, publish, circulate, and otherwise use photographs and/or motion pictures or video recordings of me and voice reproduction, captured during the CEO Summit in perpetuity.  I hereby waive the opportunity or right to inspect or approve the finished photographs, films or tapes or the use in which they may be put or the copy or illustrations used in connection therewith. 

2) I hereby release all my rights, title and interests in and to all negatives, prints, tapes and reproductions thereof, and I do hereby release the aforesaid parties and their successors and assigns, if any from any and all rights, claims, demands, actions or suits which I may or can have against them on account of the use or publication of said photographs and/or motion pictures or tapes.

I have read and understand the release stated above and do hereby agree to its terms and conditions. The release is considered signed and agreed to by completing the check box during the registration process.