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Testimonial Statement(s) – including dates made or recorded (if applicable): Transitions® Signature® GEN 8™ testimonial made via

Authorization and Release Information:

I understand my testimonial as outlined above and made on behalf of Essilor of America, Inc., including its affiliates and subsidiaries (the "Company") may be used in connection with publicizing and promoting Company, its products and services. I authorize Company to use my name or pseudonym, voice, image, likeness, biographical information and statements (including, but not limited to, photographic images, video recordings, audio recordings, images or pictures) pertaining to use of and experiences with Company’s products and services as defined on this form.

I hereby irrevocably authorize Company to copy, exhibit, publish or distribute the testimonial statements for purposes of publicizing Company's products and services or for any other lawful purpose. These statements may be used in printed publications, multimedia presentations, social media, radio, television, on websites or in any other distribution media. I agree that I will make no monetary or other claim against Company for the use of the statements. Nothing herein shall be construed to obligate Company to produce, distribute or use any of the rights granted herein.

In addition, I waive any right to inspect or approve the finished product, including video, written copy, or other medium wherein my likeness or statements appear. I understand that my statements may be used in whole or in part and may be paraphrased, amplified, modified, shortened, and/or put into conversational form to meet the requirements of copy, layout and/or script, provided their general sense is not changed. All statements reflect my honest views and experience with Company’s products and services and, if necessary, I will furnish appropriate testimonial affidavits. I will promptly notify Company if my opinion of the products or services changes from that which I express.

I represent and warrant that I have the right and authority to enter into this agreement without violating the rights of any third party and I will comply with all applicable laws, regulations, orders and ordinances in rendering the obligations stated herein.

I hereby release and discharge Company, its employees, directors, officers, agents, advertising agencies, licensees, successors, assigns and all persons acting under its permission or authority from any and all claims, demands or causes of action that I may have now or in the future for libel, defamation, invasion of privacy or right of publicity, infringement of copyright or trademark, or violation of any other right arising out of or relating to any utilization of the rights granted under this Agreement. I also release, discharge and agree to hold harmless Company, its employees, agents, licensees, successors, assigns and all persons acting under its permission or authority from any liability resulting from any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said photograph(s) or video(s) or in any subsequent processing thereof, as well as any publication thereof.

This Agreement contains the entire agreement between the parties with respect to the subject matter and supersedes all prior agreements and understandings, oral or written, between the parties with respect to the subject matter of this Agreement. This Agreement shall be construed according to the laws of the State of Texas applicable to agreements that are executed and fully performed within said State. 

I have read the authorization and release information and give my consent for the use as indicated above.