To Midwives Alliance of Hawaiʻi,

I hereby grant to Midwives Alliance of Hawaiʻi full and irrevocable permission to prepare, use, reproduce, publish, and re-publish and exhibit, my and/or my child's name, photo, video, drawing, meme, likeness, or voice, in whole or in part, composite or distorted in form. I agree they may be used in conjunction with a video or motion picture film, sound track recording, or still photography and in any and all media for illustration, promotion, education, art, editorial, advertising, trade or other purpose. I also consent to the use of any printed matter in conjunction therewith.

In addition, I waive all rights of privacy or compensation in connection with any interviews done by a representative of Midwives Alliance of Hawaiʻi or a representative of the public media for in-house or out-of-house publication of electronic reproduction.

This consent and waiver will not be made the basis of a future claim of any kind against Midwives Alliance of Hawaiʻi.