I hereby authorize the Asian & Pacific Islander American Health Forum (APIAHF), and its licensees, successors and assigns (collectively APIAHF) to republish the material  I am submitting to the Story Collection (Story Collection Submission) and also to interview, photograph, film, and/or audiotape me, and to use the Story Bank Submission and any photographs, video, audio and interview information (hereafter, collectively “Materials”) in any of its materials, including but  not limited to publications, presentations, Websites, social media, advertising, which APIAHF determines advances its goals.

I also authorize APIAHF to provide the Materials to other organizations, federal or state officials, media organizations and any other individual or organization which APIAHF believes is acting to advance its goals.

If APIAHF wishes that I participate in an event or a one on one interview, APIAHF may contact me for permission and scheduling but I am under no obligation to participate in such opportunity.   

I further understand and agree that I have no rights in the Materials, and that these Materials may be edited, used, published, distributed, republished and/or licensed by APIAHF, now or at any time in the future, for the purposes set forth in above. I waive all right to inspect or approve the use of the Materials, now or in the future.

I understand and agree that I will receive no monetary compensation for my participation or for the use of these Materials.

I release and discharge any and all actions or claims which I, my family members, or my heirs may have against the APIAHF, its officers, Trustees, employees, contractors and/or agents, and any other third party contracting with APIAHF, arising for any reason whatsoever from any use, publication, distribution, or republication of these Materials in accordance with this Consent and Release at any time now or in the future. I agree to defend, indemnify, and hold harmless APIAHF, and its employees, directors, officers, contractors, professional advisors, assignees and agents, from and against any and all claims, demands, expenses, losses or liabilities including, without limitation, reasonable attorney’s fees arising out of or in connection with any breach, or alleged breach, of the terms of this Agreement.

I am above 18 years of age and understand and agree to the terms set forth above for myself or a minor on whose behalf I am submitting.