Consent and Release Form
Latin America Executive Diamond Club/Diamond Club
By checking the “I agree” box below, I grant Alticor Inc., its subsidiaries and affiliated companies, its distributors, agents, licensees and assigns, and those acting under its permission ("Alticor"), the exclusive worldwide right to collect, own, copyright, use, reproduce, publish, publicly perform, make available to the public on the internet, license, assign, publicly display, retouch and/or alter at any time, and in any media now known or hereafter developed, photographic and/or audio visual materials depicting my image and/or any recording of my voice ("Materials"), that have been created during my attendance at this Seminar and accompanying events. Alticor may publish these Materials with my own name or fictitious names, testimonial copy or otherwise. I also consent that Alticor may publish quotes of me, under my name or under fictitious names, as well as opinions, which I have expressed during my attendance at this Seminar and accompanying events.