Release Form

Podcast Release form for Dom Dumais, in Bangkok

I hereby voluntarily and without compensation authorize pictures and/or voice recording(s) to be made of me. I hereby give permission to Dom Dumais, in Bangkok and Domnick M. Dumais to use, reproduce, and distribute the video footage, photographs, or voice recordings, including my name. I hereby agree to release Dom Dumais, in Bangkok and Domnick M. Dumais from any claims, damages or liability arising out of such use or distribution. I understand that the use of my name, likeness, and voice recordings will be primarily for the purposes of education and/or promotion by this organization. I have read and understand the foregoing and I consent to the use of my picture and/or voice as specified for the above-described purpose(s). I further understand that no royalty, fee or other compensation of any character shall become payable to me.

By adding my name and email address, I agree to the above.

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