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I hereby consent and grant to Stryker Corporation, acting through its Instruments division (“Stryker”), its legal representatives and those acting under Stryker permission and authority, the irrevocable and unrestricted right to use, reuse, copy, post, modify, alter, create derivative works, publish, perform, display, and transmit my image; certain images of my patient (“Subject”); statements made by me; audio; and/or video recordings of me, alone or with other persons (collectively “Publicity Rights”), in any and all media formats now existing or subsequently developed. I hereby acknowledge and agree that I have the consent of any other persons included in the Publicity Rights to provide the image, statements and/or recordings to Stryker. 

I hereby waive any right that I may have to inspect or approve any uses made of my Publicity Rights in connection with this Consent and Release. There is no geographic limitation on where these Publicity Rights may be exercised. 

I understand that I will not receive, and hereby waive any rights to receive any royalty or other monetary compensation, now or in the future, for this grant to Stryker of my Publicity Rights, including but not limited to the use of my images, a Subject’s images, statements made by me, videotape, or other likeness or reproductions of me and my recordings.

I hereby acknowledge that Subject waived any right that he or she may have to inspect or approve any uses made of his or her Publicity Rights in connection with this Consent and Release.

I hereby acknowledge that Subject has executed a HIPAA authorization to allow me to disclose individually identifiable health information about him or her to Stryker. 

By signing below, I acknowledge that I have completely read and fully understand the above consent and release and agree to the terms described therein and to be bound thereby.  I certify that I am over the age of eighteen (18) years and have legal capacity to sign this form.

I hereby release Stryker, its legal representatives and assigns from all claims and liability relating to the use by Stryker of Publicity Rights.