ࡱ> 9;8 nbjbj~~ M${{E( MMMMMaaa8a#0#######,%(H#MB@H#MMy]#dMM##V!@n""7a" #s#0#"T;);)n"Mn"H#H##;) + :     ɫƵ Photo/Video Release Form I, ___________________________________________ (print your full name here), grant ɫƵ absolute permission to use photographs, videos and audio recordings of me from promotional and publicity efforts in any manner or medium. I understand my image or likeness may be used, by Wesleyan or others to whom it grants permission, in publications, print materials or digital ads, direct-mail pieces, social media, digital media programs (video, audio, web), or other forms of promotion. I release the University, the photographer/video producer, their officers, employees, agents and designees from liability for any violation of any personal or proprietary right I may have in connection with such use. Furthermore, I grant permission to use my statements that were given during any interviews or lectures, with or without my name, for the purpose of advertising and publicity without restriction. I understand that all such recordings, in whatever medium, shall remain the property of others, to include ɫƵ, in perpetuity and I waive my right to any compensation. Print name: ___________________________________________________________________ Signature: ___________________________________________Date: _____________________ Address: ______________________________________________________________________ Email: _______________________________________________Phone: ___________________ If the individual is under 18 years old, have the parent or guardian sign below also: I, _________________________________, am the parent or legal guardian of the individual named above. I have read this release and approve of its terms. Signature: _______________________________________________ Date: ___________________________________     ɫƵ 2018  !"OQTrwx  ' ? 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