I hereby authorize The University of Texas at Austin (University), and those acting pursuant to its authority to:
- Record my likeness and voice on a video, audio, photographic, digital, electronic, or any other medium.
- Use my name in connection with these recordings.
- Use, reproduce, exhibit or distribute in any medium (e.g., print publications, video tapes, CD-ROM, Internet/www) these recordings for any purpose that the University, and those acting pursuant to its authority, deem appropriate, including promotional or advertising efforts.
I release the University and those acting pursuant to its authority from liability for any violation of any personal or proprietary right I may have in connection with such use. I understand that all such recordings, in whatever medium, shall remain the property of the University. I have read and fully understand the terms of this release.
Printed name:
Address:
Signature and date:
Dated signature of parent/guardian if subject is under 18 years of age: