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Consent & Release
I hereby consent, and grant Thyroid Head and Neck Cancer Foundation (“THANC”) permission, to identify me as a patient of physicians and other healthcare providers affiliated with THANC, by signs, name cards or other means, and on the Head and Neck Cancer Guide website and THANC Foundation website. I further consent, and grant THANC explicit permission, to use my name and likeness in photographs; video and/or or other digital and hard copy recordings; broadcasts and/or image preservation in digital or paper-based reproductions; in any and all of its publications; in posts on social media including, but not limited to Facebook, Twitter, Instagram, and Google+; in entries on its websites including, but not limited to the Head and Neck Cancer Guide website, without payment or any other consideration; and explicitly waive any and all royalties and any and all other forms of compensation.

I understand that, although THANC will endeavor to use my name and likeness in accordance with standards of good judgment, THANC cannot warranty or guarantee that any further dissemination of my likeness and/or image in digital and/or hard-copy reproductions will be subject to THANC supervision or control, or that such dissemination will be in compliance with applicable federal and/or state laws and regulations. Accordingly, I release, hold harmless and indemnify THANC from any and all liability related to use and/or dissemination of my name, likeness and/or image.