For valuable consideration received, I authorize the State of West Virginia to use photographs, video, and/or any other media that may pertain to me or my likeness, or my personal or real property, for the purpose of publicizing or promoting the State’s programs and activities or for any other lawful purpose.
I authorize the State to edit, alter, copy, exhibit, distribute, publish and/or re-publish such materials, in whole or in part. I understand and agree that such use by the State confers no rights of ownership upon me. I understand and agree that such materials are the property of the State and will not be returned.
I waive any right to inspect or approve the finished product in which my likeness, voice, or property appears.
I release, hold harmless, and forever discharge the State of West Virginia from all claims, demands, and causes of action which I or any other person or representative acting on my behalf, or on behalf of my estate, have or may have by reason of this Release. This Release shall be binding upon me, my legal representatives, successors, and assigns.
I hereby warrant that I am of full age and have every right to contract in my own name and or the minor in the above regard. I state further that I have read the above authorization, release and agreement, prior to its execution, and that I am fully familiar with the contents thereof.