{
	"type": "rich",
	"version": "1.0",
	"provider_name": "Action Network",
	"provider_url": "https://actionnetwork.org",
	
	"html": "<link href='https://actionnetwork.org/css/style-embed-v3.css' rel='stylesheet' type='text/css' /><script src='https://actionnetwork.org/widgets/v6/form/digital-release-form?format=js&source=widget'></script><div id='can-form-area-digital-release-form' style='width: 100%'><!-- this div is the target for our HTML insertion --></div>",
	"author_name": "Care Workers in Action",
	"author_url": "https://actionnetwork.org/groups/care-workers-in-action",
	"title": "Digital Release Form",
	"thumbnail_url": "https://actionnetwork.org//images/generic_facebook.jpg",
	"description": "I give my consent to Care Workers in Action and the Service Employees International Union, Change to Win, CLC, including all its Locals and Affiliates, (collectively, the &quot;Union&quot;) to use and publish the information I have provided to the Union. I give the Union my permission to use and publish my name, photograph, videotape, and/or any statements I have made to the Union. The Union has my permission to publish this material in print, on the Internet, over TV and radio, or through any other media. I waive any right that I may have to inspect or approve any finished products incorporating this material. I agree to release the Union from all liability and any claims that I may have arising out of the use, publication, or disclosure of this material. If I have provided my photograph and/or videotape, I further grant permission for the Union to copyright this material, and I release the Union from any liability arising from any blurring, distortion, alteration, optical illusion, or composition of my photograph or videotape.",
	"url": "https://actionnetwork.org/forms/digital-release-form"
}