RELEASE FOR USE OF DIGITAL IMAGE OR OTHER PHOTOGRAPH

I, ___________________________________ (print name of participant), in exchange for the benefits derived from my (minor child's) participation in the NSF Grant #0343447 "RUI: Biodiversity and Ecology of Tree Canopy Biota in the Great Smoky Mountains National Park" and/or the related Research Experience for Teachers supplement program at CMSU or Warrensburg R-VI Middle School, give my permission to Central Missouri State University (hereafter referenced as "CMSU") and/or to Warrensburg R-VI School District to use a digital image or other photograph taken of me (my minor child).

I acknowledge CMSU and/or Warrensburg R-VI may produce news releases and publications of various types including web-based publications and give my permission for my digital image or photograph to be used in these documents that may on occasion be distributed through print or electronic means through the United States and the world.

CMSU and/or Warrensburg R-VI may reproduce the digital image or photograph in other mediums and formats without getting my permission each time. I waive all copyright and other rights pertaining to this image. Use of the image will be only for educational, recruitment and publicity and other uses for the benefit and advancement of CMSU and/or Warrensburg R-VI and their programs.

RELEASE AND INDEMNIFICATION

I consent to the use of the photograph/image and release and indemnify CMSU and/or Warrensburg R-VI School District, their officers, employees and volunteers, even if negligent, from any and all claims, losses and damages, that may occur as a result of any uses of this digital image or photograph.

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(signature) (date)

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(address)

RELEASE MUST BE SIGNED BY PARENT OR LEGAL GUARDIAN IF IMAGE IS OF A MINOR