I give my consent to the Service Employees International Union, Change to Win, CLC, including all its Locals and Affiliates, (collectively, the "Union") to use and publish the information I have provided to the Union. I give the Union my permission to use and publish my name, photograph, videotape, and/or any statements I have made to the Union. The Union has my permission to publish this material in print, on the Internet, over TV and radio, or through any other media. I waive any right that I may have to inspect or approve any finished products incorporating this material. I agree to release the Union from all liability and any claims that I may have arising out of the use, publication, or disclosure of this material. If I have provided my photograph and/or videotape, I further grant permission for the Union to copyright this material, and I release the Union from any liability arising from any blurring, distortion, alteration, optical illusion, or composition of my photograph or videotape.