Media Release Form

I grant permission and authorization to Abriendo Puertas/Opening Doors (AP/OD) to take pictures, record, and interview me. I also give permission and authorization to copyright, publish, reproduce, distribute and/or otherwise use and reuse and republish my image, photograph(s), video, and/or comments in any format or medium (now known or hereafter developed) for any lawful purpose including but not limited to (1) print and electronic publications, (2) the AP/OD website, (3) television, (4) radio, (5) and/or AP/OD’s social media platforms for any evaluation or public use to support AP/OD’s mission.