I am authorized to submit this information to CARESTREAM DENTAL LLC (“Carestream Dental”) and that my disclosure will not breach in any way any confidentiality or other obligation to which I, or my employer, am subject.

I acknowledge that I am not a minor (under 18 years of age) and that I am legally able to act as a representative for the submitted opportunity.

I acknowledge and agree that the disclosure of this information to Carestream Dental is being made on a NON-CONFIDENTIAL basis (i.e., I am only submitting non-confidential information) and that no confidentiality obligations whatsoever are created or implied by submitting this information or opportunity to Carestream Dental.

I also acknowledge and agree that Carestream Dental may already be developing the same or a similar opportunity internally or with an external partner, as the case may be, that Carestream Dental may use the submitted information however it desires and without license, restriction, obligation, consideration or payment, and that my disclosure does not and will not create any legal relationship or obligation with Carestream Dental pertaining to the submitted opportunity.

I further acknowledge and agree that I am not relying upon Carestream Dental in any way whatsoever for legal advice, including (but not limited to) advice concerning the protection of my submission.