Media Release Form

I hereby grant DAVIS Plastic, LLC and its agents permission to use my story and/or likeness, and any photographic portraits, pictures, digital images or videos of me in any and all of its publications, including Web site entries, without payment or other consideration.

I authorize DAVIS Plastic, LLC and/or its agents to edit, alter, copy, exhibit, publish, distribute, or use my story and/or likeness, and any photographic portraits, pictures, digital images or videos of me for purposes of publicizing DAVIS Plastic, LLC or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my information appears. I understand that DAVIS Plastic, LLC owns the rights to this content and that I cannot alter and then share any content or images owned by DAVIS Plastic, LLC.

Additionally, I understand that I will not receive any royalties or other compensation arising from or related to the use of the information. I hold harmless DAVIS Plastic, LLC from any claims, demands, or causes of action which I, my heirs, representatives, executors, administrators, or any other person acting on my behalf or my estate have or may have by reason of this authorization or the use of my story, likeness, and photos. I certify by my signature that I am 18 years of age and am competent to contract in my own name.