To Whomsoever It May Concern

I hereby give my consent to Cipla Limited, it’s subsidiaries, group companies and affiliates (the “Company”), to use the aforesaid statement in all forms of media including but not limited to print, audio, video, website, internet and such other media which is in existence today for display, exhibition, broadcast, transmission, communication or any other media which may come into existence at a future date, as the Company shall deem fit and proper.

I further agree and confirm that the aforesaid testimonial along with the photograph shall become the sole and exclusive property of the Company and the Company shall have the right to use the same as it shall deem fit and proper.

I also agree and give my consent to receive e-mail notifications from the Company.

I am not, directly or indirectly, related to or having any interest (financial or otherwise) in the Company or any of its products other than as a consumer and neither been influenced in any manner whatsoever by the Company or any of its employees/agents for making this testimonial.

I hereby waive any right to inspect or approve any use of the aforesaid statement. I expressly release the Company, it’s employees, representatives, agents etc. from and against any and all claims which I have or may have for invasion of privacy or any other cause of action arising out of the uses herein granted, even if the use of the aforesaid statement is objectionable to me.

That I state that the above declarations are true to my personal knowledge and belief and I firmly believe the same to be correct.

I shall hereby agree to accept the terms of use and privacy policy of the Breathfree website