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GENERAL RELEASE FOR USE OF PICTURES AND QUOTATIONS

I hereby consent to the publication and use by PFEW of my name, biographical data, quotations or written or verbal statements about PFEW, and any official photographs taken by the PFEW staff for publicity and promotion of the PFEW program. Further, I give permission for my picture to appear on a PFEW Web Page and promotional video. (Pictures and names for the web page will only be used for promotional purposes and are simply snapshots that are taken during the program. No other identifying information will be published.)

By typing my full name below, I am agreeing to the terms above and understand that this “electronic signature” is binding as would be a handwritten signature.