Thank you for participating in our Shell Rotella Recording Booth! By signing this release form, you grant Shell Rotella and its affiliates permission to record, use, and distribute your image, voice, and statements for and purpose without limitation including promotional, educational, and commercial purposes.

CONSENT OF RELEASE

…hereby grant Shell Rotella, its representatives, affiliates, and media partners the irrevocable right to record, use, reproduce, and distribute my name, likeness, voice, image, and statements in video, audio, and photographic content captured at the Mid-America Trucking Show.
I understand and agree that:

  • My recorded content may be edited, adapted, and used in various formats, including but not limited to social media, websites, promotional materials, articles, and media.
  • Any statements, interviews, or testimonials I voluntarily provide relating to Shell, its products, services, or business, accurately reflect in spirit and content of my experience and sentiments at this time and reflect my current honestly held beliefs and truthful opinions, and I was not offered any compensation or consideration of any kind in connection to this contribution.
  • I understand that I will not receive, and hereby waive any rights to receive any compensation for participation or use of the recorded content.
  • The rights granted are perpetual, worldwide, and non-exclusive, and Shell Rotella and Coyne PR has full discretion on how the content is utilized.
  • This release applies to any and all participants, whether now known or hereafter devised.
  • I am aware that I can withdraw my consent at any time by contacting rotella@coynepr.com.
I acknowledge that I am at least 18 years of age and have the legal authority to grant this release. If under 18, a parent or guardian must sign on my behalf.

RELEASE OF LIABILITY

I release Shell Rotella, its affiliates, and representatives from any claims, liabilities, or damages related to the use of my image, voice, and statements as described in this release.
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Parent/Gaurdian Consent:

Please fill out the following fields if you are the parent or guardian and the participant if under the age of 18.
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