Information and Photograph Release

I hereby grant permission to Midlands Education and Business Alliance (hereinafter referred to as MEBA), MEBA Board members, executive director, staff, volunteers and representatives to use my name, information and photographic image, alone or in a group, in any publication or publicity release. I understand that my name, information and images may be used in print or electronic publications, website, video or other forms of media.

I hereby release Midlands Education and Business Alliance, MEBA Board members, executive director, staff, volunteers and representatives from any and all liabilities and damages which may arise at any time now or at any time in the future from the use of my name, information and photographic image related to my participation in MEBA activities.

I understand that this authorization shall remain in effect unless revoked by me and communicated to MEBA in writing with the date of revocation specified. The revocation will apply to all future use of name, information and image. I understand that revocation cannot be retroactive and hereby release MEBA from any liability and damages for name, information and images used prior to the date of revocation.