*Terms and Conditions I understand and agree to allow Scottish Rite for Children to use the information, photo and or video, I am submitting. I understand that my information may be used for marketing, publicizing, or otherwise promoting Scottish Rite for Children’s mission and that my information may be disseminated in any medium without geographic or time restriction. I authorize the release of any information including health information contained in this submission and authorize the staff of Scottish Rite for Children to discuss this information with physicians and other staff, as necessary to verify the accuracy of the information. I waive and release Scottish Rite for Children from any and all claims that I may have against Scottish Rite for Children or its officers, directors, employees, agents, or affiliates arising out of its use or dissemination this information. I also waive any right to royalties or other compensation for Scottish Rite for Children use and dissemination of this information. I assign all rights, including copyright, to the information to Scottish Rite for Children. I represent and warrant that I have the authority to provide the information to Scottish Rite for Children and that no one else owns or has superior rights to this information. I have read, fully understand, and voluntarily agree to be legally bound by this waiver, release, and authorization form. I understand and agree that I may not use this site to conduct any activity that is illegal or that violates the rights or others. I represent and warrant that all information submitted is truthful and accurate.