I (“Participant”) hereby authorize Path To Unity, LLC a Texas corporation, with a principal address at
751 Hebron Parkway, Suite 340, Lewisville, TX 75057 (“PTU”), and its agents, employees, licensees,
successors, and assigns, to photograph, record, and/or otherwise capture my name, image, likeness, voice,
statements, and appearance (collectively, the “Recordings”).

I grant PTU a perpetual, irrevocable, worldwide, royalty-free, fully paid-up license to use, reproduce,
edit, modify, distribute, publish, publicly display, perform, and create derivative works from the
Recordings, in whole or in part, in any media now known or later developed, for any lawful purpose,
including but not limited to marketing, advertising, publicity, social media, educational content, and
promotional materials.

I acknowledge and agree that:

• PTU has full editorial control and discretion over the Recordings.
• PTU is not obligated to use the Recordings.
• I waive any right to inspect or approve the final product or any future use.
• If selected to participate in a podcast, I will receive the $100 after my participation in the podcast
  is completed.

I further waive, release, and discharge PTU and its agents, employees, licensees, and assigns from any
and all claims, demands, damages, or causes of action, including but not limited to claims for defamation,
invasion of privacy, right of publicity, or emotional distress, arising out of or related to the use of the
Recordings.

I represent and warrant that:

• I am at least 18 years of age and have the legal capacity to enter into this agreement; or
• If I am under 18, a parent or legal guardian has signed below on my behalf.
• My participation is voluntary and does not violate any agreement or obligation I have with any
  third party.

This agreement shall be governed by and construed in accordance with the laws of the State of Texas.

I have read this Consent and Release Form, fully understand its contents, and voluntarily agree to its
terms.

Participant Information:

Printed Name:
Address:  
City: State:  Zip:
Phone: Email:

Participant Signature: [esigField type="signature"]

Date Signed: June 4, 2026