Vendor Credential Request

Personal Infomation

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I hereby give permission to Operation Shower, The Greater Hartford Community Foundation, Inc., as well as its subsidiaries and affiliates (collectively, the “Foundation”) and The Travelers Companies, Inc., as well as its subsidiaries and affiliates (collectively, “Travelers”), and their designees and assignees, ConnectiCare, as well as its subsidiaries and affiliates and Birdies for the Brave, as well as its subsidiaries and affiliates to capture and/or take photographs, recordings, motion pictures, digital pictures, video tape pictures and any other form of pictures, or fixed form, including name(s), likenesses, voices, of me, my family (including my children) or subjects under my control and legal custody, and capture personal stories and accounts relating directly or indirectly to me, my family (including my children) or subjects under my control and legal custody (“the Materials”) at the Drive Through Shower on June 23, 2020. I hereby give permission to the above parties to copyright, use, exhibit, reproduce, publish, display, perform (publicly or otherwise), store, archive, license and/or distribute the Materials at any time locally, regionally, nationally or world-wide in any form or medium of communication now known or hereinafter devised, whether with or without personal stories and accounts without prior notification to me and without further consideration. I understand the Materials may be used for marketing, advertising, educational, public relations, fundraising and other purposes by Operation Shower, The Greater Hartford Community Foundation, Inc., Birdies for the Brave, ConnectiCare and/or Travelers, and their designees and assignees, and/or in furtherance of Operation Shower's mission and purposes. I understand that Operation Shower will retain all ownership rights and interests in the Materials and that Operation Shower, the Foundation, Birdies for the Brave, ConnectiCare and/or Travelers, or their designees and assignees, has no obligation to use the Materials. I release and discharge Operation Shower, The Greater Hartford Community Foundation, Inc., Birdies for the Brave, ConnectiCare and/or Travelers, and their designees and assignees, from any claims or demands in any way relating to the use of the Materials relating directly or indirectly to me, my family (including my children) or subjects under my control and legal custody. By signing below I acknowledge that I have read the attached “Participant Release and Waiver,” dated June 23, 2020 provided in connection with my appearance at the Operation Shower “BABY ON BOARD” event and agree to all terms and conditions provided herein.

I hereby give permission to Operation Shower, The Greater Hartford Community Foundation, Inc., as well as its subsidiaries and affiliates (collectively, the “Foundation”) and The Travelers Companies, Inc., as well as its subsidiaries and affiliates (collectively, “Travelers”), and their designees and assignees, ConnectiCare, as well as its subsidiaries and affiliates and Birdies for the Brave, as well as its subsidiaries and affiliates to capture and/or take photographs, recordings, motion pictures, digital pictures, video tape pictures and any other form of pictures, or fixed form, including name(s), likenesses, voices, of me, my family (including my children) or subjects under my control and legal custody, and capture personal stories and accounts relating directly or indirectly to me, my family (including my children) or subjects under my control and legal custody (“the Materials”) at the Drive Through Shower on June 23, 2020. I hereby give permission to the above parties to copyright, use, exhibit, reproduce, publish, display, perform (publicly or otherwise), store, archive, license and/or distribute the Materials at any time locally, regionally, nationally or world-wide in any form or medium of communication now known or hereinafter devised, whether with or without personal stories and accounts without prior notification to me and without further consideration.

I understand the Materials may be used for marketing, advertising, educational, public relations, fundraising and other purposes by Operation Shower, The Greater Hartford Community Foundation, Inc., Birdies for the Brave, ConnectiCare and/or Travelers, and their designees and assignees, and/or in furtherance of Operation Shower's mission and purposes. I understand that Operation Shower will retain all ownership rights and interests in the Materials and that Operation Shower, the Foundation, Birdies for the Brave, ConnectiCare and/or Travelers, or their designees and assignees, has no obligation to use the Materials.

I release and discharge Operation Shower, The Greater Hartford Community Foundation, Inc., Birdies for the Brave, ConnectiCare and/or Travelers, and their designees and assignees, from any claims or demands in any way relating to the use of the Materials relating directly or indirectly to me, my family (including my children) or subjects under my control and legal custody. By signing below I acknowledge that I have read the attached “Participant Release and Waiver,” dated June 23, 2020 provided in connection with my appearance at the Operation Shower “BABY ON BOARD” event and agree to all terms and conditions provided herein.

Vendor Credential Request