Organization: MQT Innovations, Inc.

Address: 1205 Joliet Road, Marquette, MI 49855

Phone: 1-833-639-4248

Activity Description: Participation in activities where press releases, photography, and video recording may occur.

Purpose of Media Use: The media captured may be used for but not limited to local and national media (newspaper, television, radio), print advertisements (flyers, brochures, displays), and digital platforms (internet, websites, and social media sites) for purposes including advertising, marketing, and promotion.

Scope and Duration of Use: I hereby grant MQT Innovations, Inc., its representatives, and employees the right to use the aforementioned media in any and all of its publications, including but not limited to all of MQT Innovations, Inc.'s printed and digital publications. I understand and agree that this media will be used for company purposes and will be distributed in any media format for any lawful purpose, including for example, such purposes as publicity, illustration, advertising, and Web content, both now and in perpetuity.

Acknowledgment and Release: I hereby release and hold harmless MQT Innovations, Inc. from any reasonable expectation of privacy or confidentiality associated with the images specified above. I further acknowledge that participation is voluntary and that I will not receive financial compensation of any type associated with the taking or publication of these photographs or participation in company marketing materials or other company publications. I acknowledge and agree that publication of said photos confers no rights of ownership or royalties whatsoever.

Revocation: This consent is irrevocable and will remain in effect indefinitely unless explicitly revoked in writing by the undersigned.

If you are under the age of 18, a parent or legal guardian must read and sign this form on their behalf.

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