Photo/Video Consent and General Release Form

I hereby authorize the Betty J. Borry Breast Cancer Adventure Weekend, Inc. d/b/a/ the Betty J. Borry Breast Cancer Retreats to use pictures of me taken in a photograph, digital image, videotape, motion picture, and/or testimonial (written words). The undersigned hereby releases the Betty J. Borry Breast Cancer Adventure Weekend, Inc. d/b/a/ the Betty J. Borry Breast Cancer Retreats, its agents or employees, as well as any and all users and exhibitors of said pictures, from any and all claims, demands, accountings, and causes for which the aforesaid videotape, testimonial, motion picture, digital image, or photograph likeness may be used pursuant to this Consent and General Release. It is also my understanding that I will receive no compensation for my likeness or testimonial.