I hereby give my consent to be photographed and/or videotaped. I authorize and give full consent to Bayer Group, its subsidiaries, related companies, affiliates, agents, successors and assigns ("Bayer Group") to use, copyright, reproduce, publish and display any such photographs and/or video in which I appear, and to use my name, my personal information and my comments which I have either provided by video or audio recording or set forth below or attached hereto without further permission or any claim to compensation. I agree that Bayer Group may make slight stylistic modifications to my comments, which do not materially alter the original meaning. The statements, testimonials and/or quotations made by me accurately and fairly reflect my opinions or experience, and any facts that I state are true to the best of my knowledge and are based on personal familiarity with and use of the products, services, programs, or other subjects described in the statements, testimonials and/or quotations

I also agree that Bayer Group may use, or cause to be used, these photographs, video, my name, my personal information and my comments in perpetuity in newsletters, advertising and promotional materials, social media marketing channels, posters and/or on any Bayer Group website for the purpose of promoting Bayer Group and its products and services. I agree that that the photographs and/or video taken are the property of Bayer Group and/or its agent(s), and I waive any right of review or inspection.  I further consent to the collection and use of my personal information related to this release in connection with Bayer Group-sponsored or affiliated websites and social media channels. I hereby release Bayer Group from any and all claims for libel, copyright, invasion of privacy or rights of publicity pertaining to any such use. 

I hereby state that I am of legal age and capacity; that I have read or have had read to me the above Release prior to its execution; and I am fully familiar with and understand the contents thereof and understand that Bayer Group is relying on the permissions granted by me herein.


Name (please print): ________________________________________


City/State/Zip: ______________________________________________


This browser is no longer supported. Please switch to a supported browser: Chrome, Edge, Firefox, Safari.