Model and Image Release I, ________________________________________, the undersigned, Please Print 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_ ________________________________________________