I hereby give to 1199SEIU United Healthcare Workers East, their successors and assigns (collectively “1199SEIU”) my permission to create and/or commission the creation of images and/or video of me, and/or to record comments made by me (“created items”), and to edit for length, style or legal reasons, and use such images, video, and/or comments, along with my name, job title, and years of service, in printed material, videos, digital and online media, advertisements, and any other materials without payment to me for such use.

I further give to 1199SEIU my permission to use and edit for length, style or legal reasons images, and/or video of me, and comments made by me, that I have provided to 1199SEIU (“provided items”), along with my name, job title, and years of service, in printed material, videos, digital and online media, advertisements, and any other materials without payment to me for such use. I acknowledge and agree that 1199SEIU shall have sole ownership rights to any created items and/or provided items, and I hereby relinquish and waive any ownership interest which I have in such items, to the extent that any such interest exists.

I further grant 1199SEIU my permission to edit for length, style or legal reasons and use without limitation images and/or video of me and comments made by me that have been posted to publicly accessible social media sites or are otherwise publicly available (“public items”), along with my name, job title, and years of service, in printed material, videos, digital and online media, advertisements, and any other materials without payment to me for such use.

I hereby relinquish and waive any ownership interest I have in printed material, videos, digital and online media, advertisements, and any other materials containing created, provided or public items, to the extent that any such interest exists.