For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, and for and on behalf and in the name of the child(ren), I hereby consent to the unrestricted use by Ronald McDonald House Charities of the Ozarks, Inc. and The Tooth Truck, Inc. of the Child(ren)’s and our (parents) names, address, and statements, and all video or audio recordings (including, but not limited to , photographs, video tapes, films, voice recording or other representations of our family) taken of our family and any reproduction thereof in any form, style or color whatsoever, together with any writing and/or materials in connection therewith (including, without limitation, any correspondence from our family to Ronald McDonald House Charities of the Ozarks, Inc., The Tooth Truck, Inc. or McDonald’s Corporation or anyone affiliated with either organization) for purposes of publicizing the Ronald McDonald Care Mobile of the Ozarks. For and on behalf and in the name of the family, I hereby release Ronald McDonald House Charities of the Ozarks, Inc., The Tooth Truck, Inc. and McDonald’s Corporation and their respective affiliates, franchises, officers, directors, trustees, employees, volunteers, agents, and all other parties interest from any and all present or future claims, damages or causes of action for libel, slander, invasion of privacy or any other claim that the family may have arising out of, resulting from, or in connection with, such use. I hereby represent that I have read and understand this consent and release is given freely without limitation upon, or liability for, any use in connection with publicizing the Tooth Truck (Ronald McDonald Care Mobile of the Ozarks).