UNIVERSITY OF UTAH RECORDING AND PHOTO RELEASE AND

UNIVERSITY OF UTAH

RECORDING AND PHOTO RELEASE AND CONSENT FORM A

I hereby authorize the University of Utah and its ocers, agents, employees, successors, licensees, and

assigns (the “university”) to take photos and recordings of me and to and use my image, likeness, and

appearance (collectively the “photos”) without compensation to me, for any educational, nonprot,

institutional, scientic, or informational purpose. This consent is completely voluntary and up to me.

My consent herein is irrevocable and is valid for the use of the university throughout the world in any

manner or media now known or hereafter developed, including, without limitation, use on web pag-

es. The photos may be used in whole or in part, alone or with other photographs or recordings, and

may be blurred or modied. All right, title, and interest in the photos belong solely to the University

of Utah. I further give permission to the university to use my name, biography, and any other personal

information, data, events, or other material in or in connection with any such uses of the photos on the

same terms.

I understand and agree to the conditions outlined herein and hereby waive any right that I may have

to inspect and/or approve the photos or the advertising that may be used in connection therewith,

or to approve the use to which the photos may be applied. I acknowledge that I am fully aware of the

contents of this release and consent and am under no disability, duress, or undue inuence at the

time of my signing of this instrument.

Printed Name of Participant

Signature of Participant Date

Preferred pronouns

Signature of parent/guardian if under age 18 Date