Marrero 504-309-3262
Gretna 504-509-4800

I give Priority Health Care, Inc. the right to use, license or assign my image, voice and/or biographical material to publicize same, as recorded, photographed, taped and/or filmed for use in informational, promotional or commercial materials published by, or on behalf of, Priority Health Care or any of its constituent parts or affiliates in photographic, print, video, electronic, digital or any other medium now known or that may be invented in the future, without limitation, (hereinafter all of which are included in the term “Material”), and to do so with or without mention of my name, all in consideration of being included in the Material.

​​​​​​​Priority Health Care shall have complete ownership of the Material and shall have the exclusive right to license and use the Material as Priority Health Care wishes, including, but not limited to, the rights of copying, performance, display, reproduction and distribution in all media, and the right to create, perform, display and distribute derivative  works of the Material, for any purpose. I agree to indemnify, hold harmless and release Priority Health Care, its Board of Directors, employees, volunteers and agents, from and against any and all costs, claims, demands, actions or causes of action, on account of property damage or personal injury suffered by me, or property damage or personal injury of others caused by me, which may occur or result directly or indirectly from any matter or material furnished or spoken by me, or otherwise in connection with my appearance and/or the use of the Material, except to the extent those costs, claims, demands, actions or causes of action, are the direct result of any negligent act of Priority Health Care, its Board of Directors, employees, volunteers or agents. I request that this Release be construed and interpreted pursuant to the laws of the State of Louisiana, and if any portion thereof is held invalid, I request the remainder continue in full force and effect. I DECLARE THAT I COMPLETELY UNDERSTAND AND HAVE FULLY INFORMED MYSELF OF THE TERMS AND CONDITIONS OF THIS RELEASE BY HAVING READ IT, OR HAVING IT READ TO ME, BEFORE SIGNING AND I INTEND TO BE FULLY BOUND THEREBY.
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