I hereby authorize Knospe-Lerncenter GmbH to use my media in the forms and for the purposes described below.
3. Right to Revoke
I understand that I have the right to revoke this authorization at any time by providing written notice to Knospe-Lerncenter GmbH. Revocation will not affect any actions taken before the receipt of the revocation.
4. Statement of Consequences
I understand that once my media is disclosed, it could be shared publicly, including on the internet and social media platforms. I am aware that I will not receive compensation for the use of my media.
5. Authorization Validity
This authorization replaces and supersedes all previous medical release forms to the beneficiary. By signing this form, I acknowledge that any prior permissions or restrictions I may have set are null and void.
This authorization will remain in effect indefinitely, unless I request an earlier expiration date here:
Thereafter, this authorization becomes null and void. I understand that I have a right to receive a copy of this authorization.
6. Contact Information for Questions
If you have questions about this authorization or need to revoke it, please contact:
Georgstr 2, 31675 Bückeburg, Deutschland
Phone: +49 5722 9098399
Email: [email protected]
I have read and understood this authorization form. I understand that I have a right to receive a copy of this authorization.
By signing below, I agree to the terms and conditions outlined above.