PUBLICITY RELEASE ADULT National Council of La Raza 1126 16th Street, NW Washington, DC 20036 I hereby agree that the National Council of La Raza (NCLR), a nonprofit charitable and educational organization, and its staff, agents, and affiliates may photograph and video and/or audio record me in connection with NCLR s educational, informational, promotional, marketing, and other activities (the Activities ). I agree that NCLR will be the sole and exclusive owner of the results of such photographing and video and/or audio recording. NCLR shall have the sole and exclusive right, throughout the world, an unlimited number of times in perpetuity, in any media now existing, known, or hereafter created, to use, copy, publicly perform, publicly distribute (including posting on its website), store, publish, prepare derivative works with respect to, and otherwise use, reuse, or license others to use, in any manner, all or any portion thereof in connection with the Activities or otherwise. Photographs or images may include pictures of me in whole or in part, composite or retouched in character or form. I also acknowledge that NCLR may choose not to use these materials at this time, but may do so at its own discretion at a later date. I agree that, in connection with the activities consented to above, NCLR may, without compensation, permission or notification, use and license others to use my name, voice, likeness, and any biographical material concerning me which I may provide in any and all media in connection with the Activities or otherwise, and I hereby release NCLR from any claim based on publicity rights, invasion of privacy, or defamation in connection therewith. I affirm that I am over the age of eighteen (18) and have the right to contract in my own name. This agreement shall be binding upon me and my heirs, legal representatives, and assigns. I have read this agreement and I fully understand the contents of this agreement. _________________________________ Name (print) Address
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