For and in consideration of benefits to be derived from the furtherance of the educational programs of the University of Central Florida, I, the undersigned Participant, hereby authorize the UNIVERSITY OF CENTRAL FLORIDA, and any agents, officers, employees, servants or students of the University of Central Florida, to record and photograph my image and/or voice for use by the University of Central Florida or its assignees for purposes that include, but are not limited to, the creation of training and/or other informational materials, promotional materials, scientific research, quality assurance, recruiting, advertising and marketing, as well as education and teaching, at the University of Central Florida’s sole discretion.

I understand and agree that these audio, video, film and/or print images may be used, edited, duplicated, distributed, reproduced, broadcast and/or reformatted in any form and manner without payment of fees to me or to anyone else on my behalf, forever and I hereby relinquish all right, title and interest therein to the University of Central Florida.

I release the University of Central Florida, and any agents, officers, employees, servants or students of the University of Central Florida, the University of Central Florida Board of Trustees, the Florida Board of Governors and the State of Florida and their respective agents, officers, employees and servants from any and all liability relating to the taking, reproduction, and/or use of such photographs, video images, and/or sound recordings.
I hereby certify that I am at least 18 years of age and that I am legally competent to sign this form.