I hereby grant The Unity Center of New York City and Rev. Justin Epstein permission to take photographs and videos of me in connection with the COURAGE, CALMNESS AND CONFIDENCE retreat. I authorize The Unity Center, it’s assignees and transferees, to copyright, use and publish the same in print and/or electronically. I agree that the Unity Center may use such images of any lawful purposes in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of the organization and will not be returned. I waive any right to royalties or other compensation arising or related to the use of my image. I hereby hold harmless and release and forever discharge the organization from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

I have read and understand the above: