Repeal Cannabis Prohibition Act of 2012 -Endorsement and Publicity Release

Publicity Release

I, _______________________________­­­­­­­­­­___________________ [PLEASE PRINT]

hereby declare my support of the Repeal Cannabis Prohibition Act of 2012, which would add Sections 11420 et seq. to the California Health and Safety Code.

I give Sensible California permission to use my name, likeness, image, voice, and/or appearance as such may be embodied in any publicly available pictures, photos, video recordings, audiotapes, digital images, and the like. I agree that Sensible California has permission to use my name, likeness, image, voice, and/or appearance, and may use them for any purpose consistent with the Sensible California’s mission, which is to get the Repeal Cannabis Prohibition Act of 2012 on the California ballot and approved by the voters. These uses include, but are not limited to media releases, publications, advertisements, and any promotional or educational materials in any medium now known or later developed, including the Internet. I acknowledge that I will not receive any compensation for the use of my name, likeness, etc., and hereby release Sensible California and its agents and assigns from any and all claims which arise out of or are in any way connected with such use.

I have read and understood this consent and release.

I give my consent to Sensible California to use my name and likeness to promote the Repeal Cannabis Prohibition Act of 2012.

signature ________________________________________________Dated: _______, 2011

CONTACT:

Email(s):________________________________________________________

Phone___________________________________________

Mailing address________________________________

Your quote regarding the Repeal Cannabis Prohibition Act of 2012:

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©2011 Sensible California

PO Box 282, Santa Rosa, CA 95402

(707) 520-4205

Facebook: “Repeal Cannabis Prohibition”

http://sensiblecalifornia2012.orgcur

current text at: http://drfranklucido.blogspot.com/2011/10/repeal-cannabis-prohibition-act-of-2012_16.html