Marketing & Publicity Release Form

agree to grant permission and consent to Amplio Learning Technologies™ lnc. and any of its affiliates (collectively, the "Releasee") for the use and distribution, in whole or in part and without restriction as to changes or alterations, of my name, profession information, photographs, images, story and/or testimonial, including audio and visual recordings (“Released Material”) for any purpose related to the mission or business of the Releasee, including marketing in publications, news releases, online, and in other communications, and in any form of medium.

I understand that there shall be no payment for this release and no royalty, fee or other compensation shall become payable to me by reason thereof.

I understand that I may revoke this release at any time by notifying the Releasee in writing. The revocation will not affect any actions taken before the receipt of this written notification.

I shall not bring any action against the Releasee regarding the Released Material and hereby release the Releasee from any and all claims and demands arising out of or in connection with any use thereof.

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