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I, the undersigned, hereby grant to Church Mutual Insurance Company, S.I. and its agents, and affiliates (collectively, the "Company") the right to use, reproduce, and publish any of the following: my name, image, likeness, sound recording, biographical information, case study, story, statements, quotes and/or testimonials ("Content"), in whole or in part, and without restriction as to changes or alterations. I agree and understand I shall neither be compensated nor receive attribution for the Content. I further understand that this Content may be used in publications, press releases, marketing materials, advertisements (both digital and print), websites (including social media sites), or other uses. This authorization is continuous, and only I may withdraw this authorization through specific, written rescission. I hereby release, waive and forever discharge any and all claims arising out of, or in connection with, such use by the Company, including without limitation any and all claims for libel or invasion of privacy. I hereby warrant and represent that I am at least 18 years of age and have the right to contract in my own name. I have read the above Release and am fully familiar with the contents thereof. This release contains the entire agreement between the parties hereto as to the subject matter contained herein.

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