Release and Authorization to Broadcast, Photograph and Reproduce Physical Likeness and Voice

I, the undersigned, a student at Fort Lewis College, hereby expressly grant, assign and transfer to Fort Lewis College and any third party it may authorize, and to its employees, agents, assigns, successors, transferees and licensees, the right to videotape and/or photograph and/or make recordings of my voice, and the right to use pictures, silhouettes, and other reproductions of my physical likeness as the same may appear for any still-camera photograph and/or motion picture film and/or electronic image and recordings of my voice in and in connection with the exhibition and/or broadcast, theatrically or on television or radio, of any motion-picture video tape or film or tape in which my physical likeness and/or voice may be used or incorporated, and in connection with the publication of photographs in magazines, newspapers, advertising and all other publications deemed appropriate by Fort Lewis College.

I hereby release Fort Lewis College, its employees, agents, assignees, successors, transferees, licensees and/or representatives from any and all liability whatsoever to me, my heirs and/or personal representatives, as a result of any use or broadcast of such material now or at any time. I certify and represent that I have read the foregoing and fully understand the meaning and effect thereof, and intend to be legally bound.