ࡱ> <>; bjbj 4&88{{{{{j$*.{{{{{M /0!,X4XMX{M<X8 A: UNIVERSITY OF CENTRAL ARKANSAS Photo Release This Photo Release is given on the date set forth below to the University of Central Arkansas (UCA). For purposes of this Agreement, the term UCA shall refer to and mean the University of Central Arkansas, the President of UCA, any past, present and future members of the BTBoard of Trustees, any employee, representative or agent of UCA, and any entity associated with, or controlled by, UCA. I hereby grant permission to BTthe right to reproduce, use, exhibit, display, broadcast, distribute, and create derivative works of photographs or videos containing my image/likeness. I understand these images may be used for promotional, news, research, and educational purposes. For myself, and all of my heirs, personal representatives, successors and assigns, or any other persons claiming by or through me, I do hereby forever waive, release and relinquish any and all claims, demands, causes of action, liabilities, costs or expenses (including, but not limited to, attorneys fees) (all of the foregoing being referred to collectively as Claims), against BTwhich are associated with, or arise out of or in any manner are related to, anything contained in the photographs or videos. The waiver and release set forth herein waives and releases any and all Claims under any federal or state law, as well as any common law cause of action, whether in contract, tort or any other legal theory. A photocopy of this document shall be deemed to be an original. Before I signed this document, I was given the opportunity to read it. I have signed this document freely and voluntarily on the date set forth below. I certify that I am at least 18 years of age. Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ Signature: _____________________________________ Date: ___________________ Printed Name:__________________________________ Witness: _________________ .  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