CONSENT -- TO BE SIGNED BY ADULT SUBJECT OF PHOTOGRAPH

In connection with my participation in ______________________, for good and valuable consideration, I hereby irrevocably grant to ______________________ Chapter/Region of Hadassah, Hadassah, The Women's Zionist Organization of America, Inc., and each of their respective affiliates, related entities, licensees, subcontractors, representatives, successors and assigns (collectively "Hadassah") the right to photograph, film, videotape, audiotape and/or otherwise record, by any and all methods now or hereafter known, my image, voice and/or likeness and to use my name, voice, and any photograph, image or likeness in which I may appear or any utterance or statements I make, or any portion thereof, in any and all media including the Internet, any number of times, in any and all manners, and by any and all means now or hereafter known, for any trade, fundraising, promotional or other purposes, without approval. I agree that any photograph, image or likeness, utterance or statement shall be Hadassah's sole and exclusive property. I hereby release Hadassah from any and all liability in connection with the use of my name, voice and/or any photograph, image, likeness, utterance or statement.

I acknowledge that I have read and understand this Consent and that it shall be binding on me and my heirs. Please fill out and return to: Hadassah Chicago Chapter, 4711 Golf Rd. Suite 600, Skokie, 60076.

Name: ______________________________________
Signature: ___________________________________
Address: ____________________________________
Date: _______________________________________


CONSENT -- TO BE SIGNED BY PARENT OF SUBJECT OF PHOTOGRAPH (IF SUBJECT IS UNDER 18)

In connection with my participation in ______________________, for good and valuable consideration, I ______________________ (name) as parent/legal guardian of ______________________ (child),hereby irrevocably grant ______________________ Chapter/Region of Hadassah, Hadassah, The Women's Zionist Organization of America, Inc., and each of their respective affiliates, related entities, licensees, subcontractors, representatives, successors and assigns (collectively "Hadassah") the right to photograph, film, videotape, audiotape and/or otherwise record, by any and all methods now or hereafter known, my child'simage, voice and/or likeness and to use my child's name, voice, and any photograph, image or likeness in whichmy childmay appear or any utterance or statementsmy child maymake, or any portion thereof, in any and all media including the Internet, any number of times, in any and all manners, and by any and all means now or hereafter known, for any trade, fundraising, promotional or other purposes, without approval. I agree that any photograph, image or likeness, utterance or statement shall be Hadassah's sole and exclusive property. I, on behalf of myself and my child,hereby release Hadassah from any and all liability,including claims that have not yetarisen or matured,in connection with the use of my child's name, voice and/or any photograph, image, likeness, utterance or statement.

I acknowledge that I have read and understand this Consent and that it shall be binding on me and my heirs. Please fill out and return to: Hadassah Chicago Chapter, 4711 Golf Rd. Suite 600, Skokie, 60076.

Name: ______________________________________
Signature: ___________________________________
Address: ____________________________________
Date: _______________________________________