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For good and valuable consideration, the above signed hereby grants the GEORGIA INSTITUTE OF TECHNOLOGY (“GIT”) and the GEORGIA TECH RESEARCH CORPORATION (“GTRC”) the absolute and irrevocable right and permission, in respect to the photographs, video tapes, motion pictures, recordings, or any other media (hereinafter collectively known as “Images”) that GIT/GTRC has taken of me or my property, or minors in my care, or in which I may be included with others, to copyright the same, in GIT/GTRC’s own name or otherwise, to use, re-use, publish, and re-publish the same in whole or in part, individually or in conjunction with other images, and in conjunction with any printed or electronic matter, in any and all media now or hereafter known, and for any legitimate purpose whatsoever, and to use my name in connection therewith if GIT/GTRC so chooses. I hereby waive any right to inspect or approve the Images or any finished version incorporating the same. The above signed does hereby release and forever discharge GIT, GTRC, and the Board of Regents of the University System of Georgia, their members individually, and their officers, agents, and employees of any kind from all claims, demands, rights, and causes of action of whatever kind or nature, arising from and by reason of any and all known and unknown, foreseen, and unforeseen injuries, damages, and the consequences thereof resulting from the use of the Images, including without limitation any and all claims for libel or invasion of privacy. I understand that the acceptance of this release and waiver of liability by the Board of Regents of the University System of Georgia shall not constitute a waiver, in whole or in part, of sovereign immunity by said Board, its members, officers, agents, and employees. This authorization and release shall also inure to the benefit of the heirs, legal representatives, licensees, and assigns of GIT, GTRC, and the Board of Regents of the University System of Georgia. I hereby certify that I am suffering under no legal disabilities and that I have read the above carefully before signing. This release shall be binding upon me and my heirs, legal representatives, and assigns. By signing above, I agree to the terms stated above and hereby certify that I am 18 years of age or older.

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