Please do not enter N/A in the Learning Objectives section. Three learning objectives are mandatory to meet any continuing education requirements. We appreciate your cooperation.

By submitting this form, I grant permission to the American Association of Nurse Life Care Planners (including its assigns and transferees), the rights of my image, in video or still, and of the likeness and sound of my voice as recorded on audio or video tape with or without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area. The entire full presentation remains the property of The American Association of Nurse Life Care Planners.
Photographic, audio or video recordings may be used for any purpose, including but not limited to, marketing, advertising, publicity, or other promotional purposes.

Online/Internet Videos/Photographs/Social Media postings
Media – including but not restricted to: The American Association of Nurse Life Care Planners News (Press)

By submitting this form, I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in the public educational setting. I will be consulted about the use of the photographs or video recording for any purpose other than those listed above.

There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.

This release applies to photographic, audio or video recordings collected as part of the sessions listed on this document only.

By submitting this form, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against the American Association of Nurse Life Care Planners, their employees, agents, representatives and assigns.