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Testimonial Release Form

Authorization and Release Information

SELECTiON.COM® intends on using the testimonial to publicize the company. YOU CHOOSE what we include:

I understand that SELECTiON.COM® may use my testimonial in connection with publicizing SELECTiON.COM®, its activities and its business to the general public. I also authorize SELECTiON.COM® to use my name and information, only as I have selected on this form.

SELECTiON.COM® intends on using the testimonial for lawful advertising purposes and you will not be compensated:

I hereby authorize SELECTiON.COM® to copy, exhibit, publish or distribute my statements for any lawful purpose. My statements may be used in printed publications, multimedia presentations or on websites, to be displayed in the way I have specified on this form. I agree that I will make no monetary or other claim against SELECTiON.COM® for its use of my statements.

I hereby waive any right to inspect or approve any finished product, including written copy, where my statements appear.

I hereby release and hold SELECTiON.COM® completely harmless from all liability in connection with any claim, demand, and / or cause of action that I, my heirs, executors, administrators, representatives or any other persons acting on my behalf, or on behalf of my estate, may have or claim to have by reason of this Authorization and Release.

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