As a participant in the Spark™ Testimonial Campaign: I hereby grant permission to Ormco B.V., its affiliates, representatives, employees, and assign Ormco, to use my Testimonial and/or likeness in any and all of its publications, including website entries, without payment or any other consideration.

I understand and agree that these materials will become property of Ormco B.V. and will not be returned. I hereby authorise Ormco, to exhibit, publish, or distribute, this Testimonial and/or likeness for purposes of publicising Ormco’s Spark™ PMCF or for any other lawful purpose. 

I understand that neither I nor my employer will have any right to compensation in connection with the above granted rights. I hereby release Ormco from any and all Claims and liability related to said Testimonial and/or likeness as agreed to in this document, including without limitation any Claims based on libel, the right of publicity or privacy. 

I am at least 18 years old and have the right to contract in my own name. This agreement shall be binding upon me and my heirs, legal representatives and assigns. 

I have read the above consent and release and fully understand the contents thereof.