Limited Personal Release Agreement Please complete the following form prior to your interview

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Grant

For consideration which I acknowledge, I grant to ASET – The Neurodiagnostic Society (“ASET”) and ASET’s assigns, licensees, and successors, the right to use my audio recording for the following purposes:

To share online on its website, YouTube, or other platforms for an unlimited period of time.

I grant the right to use my name and audio (voice) recording for the purposes listed above in all forms and media, including edited versions, and waive the right to inspect or approve versions of my recording used.

Release

I release ASET and ASET’s assigns, licensees, and successors from any claims that may arise regarding the use of my audio recording including any claims of defamation, invasion of privacy, or infringement of moral rights, rights of publicity, or copyright. ASET is permitted, although not obligated, to include my name as a credit in connection with the recording.

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