I, Samson Distributor, hereby authorize Samson Corporation to use, reproduce, and/or publish photographs and/or video that may pertain to me—including my image, likeness, and/or voice without compensation. I understand that this material may be used in various publications, public affairs releases, and recruitment materials, broadcast public service advertising (PSAs) or for other related endeavors.

This material may also appear on Samson Corporation's or project sponsor's Internet Web Pages. This authorization is continuous and may only be withdrawn by my specific rescission of this authorization. Consequently, Samson Corporation or project sponsor may publish materials, use my name, photograph, and/or refer to me in any manner that Samson Corporation or project sponsor deems appropriate in order to promote/publicize service opportunities.