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Release to Use Image, Name and Personal Information

I, the undersigned, have voluntarily participated in an interview, testimonial, and/or media event (“Appearance”) with InCharge Debt Solutions (“InCharge”). In connection with my Appearance, I hereby grant to InCharge, its affiliate entities, and their respective employees, agents, and representatives, permission to use, adapt, modify, reproduce, distribute and display my image, name, interviews, stories and personal information as it deems appropriate exclusive of confidential, private identifying information (“Personal Information”) by incorporating it into publications, brochures, internet websites and/or other media (the “Works”). I waive any right to inspect or to approve any Works that may be created using the Personal Information and waive any claim with respect to the eventual use to which the Personal Information may be applied. The Personal Information may be used at InCharge’s sole discretion except that InCharge will not use the Personal Information for any criminal or illegal purposes or in a manner inconsistent with community standards or decency. I waive any and all right to payment or other compensation arising from or related to the Works. I understand and agree that InCharge is and shall be the exclusive owner of all right, title and interest, including copyright, in the Works. I release and hereby agree to indemnify, defend, and hold harmless InCharge, its agents, employees, licensees and assigns from any and all claims I, or any third party, may have now or in the future for invasion of privacy, right of publicity, copyright infringement, defamation or any other cause of action arising from the use of the Personal Information. I am of full legal age and have read this Release and am fully familiar with its contents. I understand that this Release is governed by the laws of the state of Florida.

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