By giving permission, I hereby release Providence Talks and Federal Hill House from any liability arising from the authorized use of this information by Providence Talks or its listed designee and indemnify Providence Talks for any claims arising therefrom.
By giving permission, I hereby authorize Providence Talks employees to contact me for a phone interview for the purpose of improving the overall quality of the program.
This authorization to use to disclose this information shall remain in effect until unless I revoke it in writing at any time by sending written notification to:
Assistant Director, Providence Talks, Roger Williams University, 1 Empire Plaza, Providence RI 02903
Promotional or educational materials and videos that use any of the below-listed information and are produced while this authorization is in effect can be used by Federal Hill House, Providence Talks and its agent for a period of six (6) years from the date of production. These materials and videos remain part of the agency’s historical record.