Please complete form by May 25, 2026.

NATIONAL TELEVISION & MEDIA APPEARANCE RELEASE

I, the undersigned, hereby grant EARTHCANDY ARTS, EARTHCANDY TRAVELS, Jamila Crawford Pécou, and their affiliates, production partners, broadcasters, licensees, successors, and assigns permission to use my name, image, likeness, voice, appearance, photographs, and video footage captured during any EARTHCANDY retreat, gathering, excursion, or related event for television and media purposes.

I specifically acknowledge and agree that such footage and materials may be submitted to, aired on, distributed by, or otherwise used in connection with national television programming, streaming platforms, documentaries, promotional campaigns, news/media features, social media, and other public broadcast or commercial media formats now known or later developed.

I understand that:
• My participation and appearance may be publicly displayed and viewed by a wide audience.
• I will not receive compensation, royalties, or ownership rights related to such use.
• EARTHCANDY ARTS and its media partners retain full editorial and creative discretion regarding how the footage is edited, presented, and distributed.
• I waive any right to inspect or approve the final production or its use.

I hereby release and hold harmless EARTHCANDY ARTS, EARTHCANDY TRAVELS, Jamila Crawford Pécou, broadcasters, networks, production companies, and affiliated parties from any claims arising out of the use of my likeness, voice, or participation in connection with such media use.

This authorization is granted voluntarily and shall remain valid worldwide and in perpetuity.