Medical City Dallas Hospital
Consent and Release

By agreeing to these terms, you hereby consent to permit Medical City Dallas Hospital to use your name, voice, signature, photography and/or likeness:

(1) in connection with any related commercial or non-commercial purposes,
including but not limited to, marketing, advertising, fundraising,
development, public relations, sciences and education; and

(2) in the form of media, including but not limited to, articles, brochures,
pamphlets, advertisements, newspapers, film, live television transmission,
videotape, radio broadcast, and internet web site.

You grant Medical City Dallas Hospital permission to use materials containing your name, voice, signature, photograph, and/or likeness as it deems reasonably appropriate.

You waive all rights that you may have to any claims for payment or royalties for the use of your name, voice, signature, photograph, and/or likeness.

You hereby unconditionally release Medical City Dallas Hospital, its subsidiaries, assigns, successors, parent affiliated corporations and operations, officers, directors, agents, and employees, their assigns and successors, from any claims, actions or causes of action, or liabilities arising out of the use of such materials.