Release FormFor photo or video models only "*" indicates required fields First Name* Last Name* Email Address* Preferred Phone*Agreement* I agree to the privacy policy.AGREEMENT I, the undersigned, do hereby consent and agree that UCO Media Group, LLC, its employees, or agents have the right to take photographs, video, or digital (audio) recordings of me and to use these in any and all media, now or hereafter known, and for any marketing communication purposes. I further consent that my name and identity may be revealed therein or by descriptive text or commentary. I do hereby release to UCO Media Group, LLC, its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately and to market and sell copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used. I also grant creative permission to alter any media recordings of me. I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback. I also understand that UCO is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result. I represent that I am at least 18 years of age, have read and understood the foregoing statement, and am competent to execute this agreement.Electronic Signature* Date MM slash DD slash YYYY I am a parent/guardian signing on behalf of the individual above. Yes No CAPTCHANameThis field is for validation purposes and should be left unchanged.
