Our street‑interview content, brand assets, and media documentation.

1Participant

Full legal name Email address (required) Phone (optional)

I consent to being interviewed, photographed, and recorded (audio/video) by Paidvine / Survey Sherpa, including my image, voice, and statements ("Media") — across photos, video, audio, livestreams, social content, ads, and promotional/marketing materials.

2Release

I grant Paidvine / Survey Sherpa, its affiliates, successors, licensees, and assigns ("Company") an irrevocable, worldwide, perpetual, royalty‑free right to use, reproduce, edit, publish, distribute, and display the Media for commercial, promotional, advertising, educational, and business purposes in any medium now known or later developed — including the right to edit, crop, modify, or combine it with other materials at the Company's discretion.

3Compensation

Compensation type Select one Cash / Gift Card Other

4Release & Waiver

I release and hold harmless the Company and its representatives from claims arising from use of the Media, including claims related to privacy, publicity rights, defamation, or emotional distress.

5Representations

I confirm I am at least 18 years old (or have parent/guardian consent), have the authority to grant this release, and understand its contents.

✓Signature

Type your full legal name — this is your signature

Signed electronically on submission. Date is recorded automatically.