Authorization and Release

By clicking the “SUBMIT” button below, I hereby give the California Dental Association, its legal representatives, agents, and assigns, and all persons acting with its permission and authority (the “CDA Parties”), the absolute right and permission to print, publish, broadcast, and use, world wide in any media now known or hereafter developed, including but not limited to the world wide web, at any time or times, my name, biographical information, and story for advertising, trade, and promotional purposes without additional consideration, compensation, permission, or notification. I hereby release and discharge the CDA Parties from any and all claims and demands arising out of or in connection with the use of my name, biographical information, and story, including any and all claims for libel, slander, invasion of privacy, copyright or trademark violation, right of publicity, or false light.