Digital Photo & Media Consent Form

Thank you for choosing Road Worthy NEO! By participating in our program, you help us share the story of how reliable transportation creates new job opportunities in Northeast Ohio.

To help us promote this mission to the press and our community, we ask that you review and sign this media release.

Media Release and Consent

I, the Participant, hereby grant permission to Road Worthy Inc. and its authorized agents, assignees, and partners (“Road Worthy”) to photograph, film, and record me, and to use my name, likeness, and voice in connection with the Road Worthy NEO vehicle recipient program.

Authorization Scope

  • Usage Rights: I grant Road Worthy the irrevocable, perpetual right to use, reproduce, edit, and distribute any photographs, video, or audio recordings of me (“Materials”) in any media now known or developed in the future.
  • Purpose: I understand these Materials may be used for marketing, promotional, educational, and public relations purposes, including:
    • Social media (e.g., Facebook, Instagram, LinkedIn).
    • Road Worthy NEO website and newsletter.
    • Press releases, media kits, and news articles (print, television, or online).
    • Fundraising materials and grant applications.
  • No Compensation: I understand I will receive no financial compensation for the use of these Materials.
  • Release of Liability: I release Road Worthy, its board members, employees, volunteers, and partners from any claims, demands, or causes of action arising from the use of the Materials, including claims for defamation or invasion of privacy.

Digital Signature

By entering your name below and checking “I Agree” and submitting this form, I confirm that I have read and understood this release, that I am 18 years of age or older (or have parent/guardian consent), and that I voluntarily provide my consent.

Media Release

Road Worthy NEO values your help in telling the story. Please complete this form to allow Road Worth NEO and its partners to utilize your photo, video or verbal / written statement for marketing purposes.

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Do you agree with the media release