Name

First Name

Last Name

I permit ICON Ministry to use my image and my voice for the Catholic Influencers Podcast and promotion on social media. This consent includes, but is not limited to: a) Permission to interview, film, photograph, or otherwise make a video reproduction of me and/or record my voice; b) Permission to use my name; image and/or voice in pre-event promotion across all media including the internet. c) Permission to use quotes from the interview(s) (or excerpts of such quotes), the film(s), photograph(s), or reproductions(s) of me, and/or recording(s) of my voice, in part or in whole, in its print and digital media (including the Internet). *

I understand and agree to these terms