Authorization, Release & Waiver of Liability I hereby grant permission for myself (or individuals under my guardianship) to AAdvantage, Inc. and it's subsidiaries, it's employees, designees, agents, independent contractors, and legal representatives, to be photographed, interviewed, videotaped, and/or take part in any marketing collateral, radio or TV program, video, internet or intranet production (herein referred time as "the product"), and to be identified by name in said marketing collateral, photographs, news stories, videos and/or broadcasts which the authorities of AAdvantage, Inc. and its subsidiaries which include Arc Human Services, Inc., Residential Recovery Services, Arc Washington and AAdvantage Foundation consider appropriate and fitting for release for publications, broadcast, and/or online purposes. I authorize that any information voluntarily disclosed by me can be published, reproduced, edited, exhibited, projected, displayed and/or copyrighted as photographic images of me or my child (ren). This information may be included in whole or part, through any form of media (print, digital, electronic, broadcast, or otherwise) and can be used for art, advertising, recruitment, marketing, fund raising, publicity, archival, or any other lawful purpose. I waive any right to inspect and approve the finished product that may be used or applied now or in the future, whether known or unknown to me, and to any royalties or other compensation arising from or related to the use of the product. I release and agree to hold harmless AAdvantage, Inc. and it subsidiaries, its board, officers, employees, contractors, and/or agents of and from any liability by using any testimonial or biographical data, whether intentional or otherwise. Further, I expressed acknowledge;• That I am at least 18 years of age (or if under 18 years if age, that I am joined herein by my parent or legal guardian)• This authorization is voluntary, under no duress, and without expectation of compensation in any form or in the future• This authorization shall be valid until until it is revoked by me in writing. • This authorization may be revoked by me at any time, provided I notify AAdvantage, Inc. and its subsidiaries in writing. Any revocation shall not apply to the extent that AHS has taken any action in reliance on this authorization. • That any private information (including Protected Health Information) I voluntarily disclose can no longer be protected by AAdvantage Inc. and its subsidiaries or HIPPAA Privacy and Confidentiality Rules. I understand that this agreement has been made in, and shall be construed pursuant to, the laws of the Commonwealth of Pennsylvania.