Collaborating for the Advancement of Interdisciplinary Research in Benign Urology

CONSENT AND RELEASE FORM

Virtual seminars and forums organized by the CAIRIBU Interactions Core and CAIRIBU affiliates will be recorded. Recordings will capture any or all of the following: PowerPoint or other presentation materials shared by presenters and event organizers; video of presenters and event participants; audio of presenters and event participants (e.g., during discussion and Q&A), and still photographs and/or screenshots of presenters and participants.

Please consider providing your consent to disseminate any recording(s) of you during the specified event. This covers all information and materials you shared during your presentation(s). Your consent covers the dissemination of your presentation(s) in all formats and media for an unlimited period of time. This may include posting on the CAIRIBU YouTube channel, on the CAIRIBU website, on the CAIRIBU Twitter account, and/or on the websites or social media of individual CAIRIBU Centers and Programs. Full credit to you will be provided in any dissemination; you will be identified by name and the affiliation under whose auspices you delivered the presentation. You may request the exclusion of certain slides or images from broad dissemination. Your consent herein in no way restricts the publication or dissemination by you or anyone authorized by you of this material in any form.