Nominees must be fluent in written and spoken English and are advised to apply early due to limited slots.

I hereby grant permission to CENTRE FOR COMMUNICATION AND SOCIAL IMPACT (hereinafter referred to as CCSI, which expression shall where the context so admits include its successors, agents, licensees and assigns) to photograph me, record my voice and use my picture, photograph, silhouette, digital images, real life stories and other reproductions of my physical likeness, sound and name as part of the Leader in Strategic Communication Masterclass Series, and further grant permission for the unlimited distribution, advertising, promotion, exhibition and exploitation of the Picture or sound by any method or device now known or hereafter devised in which the same may be used, and/or incorporated and/or exploited. I ALSO FURTHER AGREE THAT I will not assert or maintain against CCSI, its successors, assigns and licensees, any present or future claim, suit, or demand of any kind or nature whatsoever including but not limited to, those grounded upon invasion of privacy, rights of publicity or other civil rights, or for any other reason in connection with CCSI’s authorized use of my physical likeness, sound, real life stories and name on the Leader in Strategic Communication Masterclass Series herein provided.  I HEREBY RELEASE CCSI, its successors, assigns and licensees, and each of them, from and against any and all legal claims, liabilities, demands, actions, causes of action(s), costs and expenses whatsoever, at law or in equity, known or unknown, anticipated or unanticipated, which I had ever had, now have or may, shall hereafter have by reason, matter, cause or thing arising out of the use as herein provided. I FURTHER AFFIRM THAT I did not receive or intend to receive any form of compensation from CCSI, its representatives, agents, successors or assigns on account of this use.