UNIVERSITY OF MISSOURI
RELEASE
AUTHORIZATION TO RECORD AND REPRODUCE LIKENESS, WORDS, TALENT, ACTIONS, PHOTOGRAPHS, ILLUSTRATIONS, AND GRAPHICS,
I, the undersigned, grant to THE CURATORS OF THE UNIVERSITY OF MISSOURI and their successors, assigns, grantees, licensees, bailees, and permitees the right to record, reproduce, and exhibit my likeness, words, talent, actions, photographs, illustrations, graphics and names.This action is given for the purpose of producing_____________________________________________ ___________________________________________________________________________
I agree that I have read the above statements and understand the terms of this release.
Name:___________________________________________________
(signature)
Date:____________________________________________________
(month) (day) (year)