Media Release and Authorization

This Media Release and Authorization will ensure that any media (if any) released to journalists covering the event will only include your name and likeness if you authorize our use. Additionally, this form will enable us to use your name and likeness on any future marketing materials, if you agree.

Signatories Agree to the Following Statements:
II grant to IndigiData and to any organizers or entities authorized by IndigiData, such as the Native BioData Consortium, the right to use my name, likeness, picture, image, and other information in connection with the production, promotion, advertising and running of IndigiData in all media and distribution channels of any kind, including noncommercial use.

I acknowledge that I am agreeing to participate in this activity voluntarily and without compensation. I release and discharge IndigiData and any organizers or entities authorized by IndigiData from any and all claims and demands arising out of or in connection with any use of my name, likeness, picture, image, and other information including, without limitation, all claims for invasion of privacy, infringement of my rights and publicity, defamation and any other person and/or property rights.

I may revoke this Authorization at any time. My revocation will be effective upon receipt and will apply to any and all future uses. My revocation must be in writing, signed by me or on my behalf, and sent or delivered to the following address: Attn: Krystal Tsosie, 220 E Prairie Road, PO Box 1587, Eagle Butte, SD 57625.