I hereby authorize MaineHealth and its programs and members to republish the material I am submitting to the Story Bank (Story Bank 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 media generated by or on behalf of MaineHealth or its members -- including but not limited to publications, presentations, Web sites, social media, and/or advertising -- which MaineHealth determines advances its goals.
I also authorize MaineHealth and its programs and members to provide the Materials to other media or healthcare or advocacy organizations, federal or state officials, agencies and/or legislators or their staff, and any other individual or organization which MaineHealth and its programs and members believes is acting to advance its goals.
If MaineHealth and its programs and/or members wish that I participate in an event or interview, they may contact me for permission and scheduling but I am under no obligation to participate in such activities.
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 MaineHealth, its programs and members, now or at any time in the future, for the purposes set forth 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 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.