Consent Form

Permission to publish and use photos and videos

First name

Last name

E-mail

I hereby authorize LOU-TEC to use my image in photographs, videos and other media, my voice, as well as my professional information for the following purposes: - Publication for the purposes of professional activities of LOU-TEC. I understand that my image may be used in various formats, including but not limited to print, digital and online media. I also understand that my image may be modified for use in various formats. I hereby waive any right to inspect or approve the finished product or use of my image, including any written or electronic copies associated therewith. I acknowledge that LOU-TEC has the right to use my image for the purposes described in this consent form. I waive any compensation from LOU-TEC for the use of my image and release and hold harmless LOU-TEC from any claim, damage or liability arising from the use of my image, as described in this consent form. I acknowledge that I have read and understood this consent form and that I am over 18 years old. If I am under the age of 18, I acknowledge that my parent or legal guardian has read and understood this consent form and has given consent on my behalf.

The form is sent. THANKS !