I hereby grant the County of Wayne & Wayne UNC Health Care permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.


I understand and agree that all photos will become the property of the County of Wayne and will not be returned.


I hereby irrevocably authorize the County of Wayne to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose.  I waive any right to inspect or approve the finished product wherein my likeness appears.  Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.


I do hereby release and forever discharge and hold harmless the County of Wayne from any and all liability, claims, and demands of whatever kind or nature which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.