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Please fill out the Photo & Video Release Form below:

I do hereby completely release, acquit, hold harmless, and forever discharge Wayman L. Tisdale Foundation Inc. and Executive Director , Board of Trustees, its agents, affiliates, of any and all responsibility, present or future claims, suits, obligations, liabilities, causes of action, demands, damages, costs and expenses of any nature whatsoever, known or unknown, in law, equity or otherwise, which I now have or which may here after accrue on account of, result from, or in any way arises out of or in connection with, the prosthesis and related services. This Release shall be binding upon the executors, administrators, personal representatives, heirs, successors, and assigns of the undersigned.