Model and Image Release

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Model and Image Release
I, ________________________________________, the undersigned,
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do hereby grant Michigan Technological University, or anyone Michigan
Tech may designate,full permission to use and reproduce for any legal
purpose all photographs and/or recordings taken by Michigan Tech in
which my image or voice may appear. I hereby waive any and all claims
to said photographs or recordings and to compensation for their use.
This release is executed gratuitously and/or for any self-satisfaction
which I may derive from any publication or programs in which my
photograph or voice will appear.
Signature_____________________________ Date_ _______________
Model or Agent
Signature of guardian_______________________________________
If Under 18 Years of Age
Email _____________________________________________________
Telephone_ ________________________________________________