For good and valuable consideration, the sufficiency of which is hereby acknowledged, I hereby grant the Georgia Hospital Association, Inc. and its affiliates and subsidiaries (collectively, “GHA”) an irrevocable, non-exclusive, royalty-free, sublicensable, perpetual license to use, display, publish, post, reproduce, and allow others to use, display, publish, post, and/or reproduce my written quote (“Testimonial”), in whole or in part, individually or in conjunction with other testimonials or printed or electronic matter, in any media or format now or hereafter known, including on the World Wide Web, social media, or in any other manner, for educational, public health, promotional, or any other purpose within GHA’s mission, and to use my name in connection therewith if GHA so chooses, free of payment or other compensation of any kind to me. I hereby waive any right to inspect or approve GHA’s use of the Testimonial or any finished display incorporating the same. I understand that the Testimonial shall be readily accessible by the general public. I acknowledge and agree that GHA shall not be responsible for any use of the Testimonial by any third party accessing the Testimonial through the World Wide Web or any other manner. I agree that this release also includes authorization to GHA for use or disclosure of any protected health information that I may have included in my Testimonial for the purposes and in the manner stated above.

I hereby agree to hold GHA and its members, officers, and employees free and harmless from any and all liability arising out of the Testimonial and any use of the Testimonial. I hereby release and forever discharge GHA and its members, officers, and employees individually from all claims, demands, rights, and causes of action of whatever kind, arising from and by reason of any known or unknown, foreseen or unforeseen injuries, damages, and the results thereof resulting from the use of the Testimonial, including without limitation, claims of slander, libel, invasion of privacy, rights of publicity, or copyright violation. This license and release shall inure to the benefit of the heirs, legal representatives, licensees, and assigns of GHA. This release shall be binding upon me and my heirs, legal representatives, and assigns.