CAREFULLY READ THE FOLLOWING RELEASE AGREEMENT.

YOU ACCEPT AND AGREE TO BE BOUND BY THIS RELEASE AGREEMENT BY CLICKING THE CHECKBOX LABELED
"I AGREE" THAT IS DISPLAYED BELOW.

I, the undersigned, do hereby voluntarily authorize and give my consent and permission to the Hydrocephalus Association ("HA") to own and use: (1) any and all photographs (the "Photographs") I have posted or will post to the Internet for HA's commercial and/or non-commercial purposes; (2) my likeness, name, and images of me in the Photographs (collectively "Likeness") I have posted or will post to the Internet for HA's commercial and/or non-commercial purposes.

I confirm that I have the right to enter into this Release Agreement, that I am not restricted by any commitments to any third parties that would have a bearing on this Release Agreement, and that I have obtained any and all applicable releases from all third parties that appear in the Photographs.

I hereby give all consent and clearance under all applicable law for HA's use of the Photographs and my Likeness, and I expressly release and indemnify HA from any and all claims known and unknown arising out of or in any way connected with the above granted uses and representations. The rights granted to HA herein are perpetual and worldwide and shall survive my death and any other occurrence.

From the date of my acceptance of this Release Agreement, I hereby grant, release and assign to HA any and all ownership and/or claims of right whatsoever in and to all Photographs and derivative works created therefrom.

In consideration of all the above, I hereby acknowledge receipt of reasonable and fair consideration received in the form of free advertising and promotion for the Photographs and my Likeness.