I hereby give consent to Shine Dental Associates of the North Shore to photograph, videotape, or otherwise digitally record and use images and/or sound recordings of myself or my child or children (if applicable) to use in any public media, including radio, television, internet, social media, print or in any of the organization’s or its partners’ publications, productions, or posts. I understand that the intended use of such images and information is solely for the purpose of advertising, marketing, fundraising, and/or promotional and public awareness purposes for the organization. I hereby waive any rights or interest in the images or recordings as contemplated in this release. I acknowledge that this consent to use images and/or recordings is being made solely for the organization’s benefit and comes without any expectation of monetary compensation or other benefit to me. To the extent that any benefit accrues or might accrue to the organization from the use of images or information, I hereby and forever waive any interest in or claim to such benefits. I hereby release and forever discharge the organization (including without limitation all corporate affiliates and officers, directors, trustees, donors, employees, agents, and volunteers) from any and all claims, liability, actions, suits, demands, costs, expenses, or indebtedness arising out of, related to, or in any way connected with the use of images and materials described herein. I hereby waive all rights and interest in and to such information and materials. I further acknowledge that there is no guarantee that any or all of the participants’ images or recordings will be used in any released media. I have been informed that this authorization is voluntary and is subject to revocation at any time, except to the extent that action has been taken in reliance thereon, by notifying Shine Dental Associates of the North Shore in writing at: