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I hereby grant the National Fragile X Foundation (NFXF) full permission to use either my name (if necessary) and my image or my child's name (if necessary) and image in any publication, advertising materials (printed or electronic) or online videos (including YouTube) without payment or any other consideration in perpetuity.

I hereby authorize the NFXF to edit, alter, copy, exhibit, publish or distribute the image. I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my image appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the image.

I hereby hold harmless and release and forever discharge the NFXF from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf of on behalf of my estate which may have or may have by reason of this authorization.

Please note that not all images will be used.

I am 18 years of age or older and am competent to contract in my own name. I have read this release, and I fully understand the contents, meaning, and impact of this release.