For good and valuable consideration, the sufficiency of which is hereby acknowledged, Participant (as identified above) agree as follows:

1. During my enrollment and participation in the workshop* (hereinafter “Activity”), I understand that I may be videotaped, photographed and/or recorded. I hereby grant permission and authorize The Board of Regents of the University System of Georgia by and on behalf of Georgia Institute of Technology (“Georgia Tech”) to videotape, photograph and/or record me, my voice and/or my property during my enrollment and participation in the Activity(hereinafter collectively known as “Image”).

2. I hereby grant to Georgia Tech and Georgia Tech Research Corporation (“GTRC”) an irrevocable, non-exclusive, royalty-free, sublicensable, perpetual license to use, display, publish, post, reproduce and allow others to use, display, publish, post, and/or reproduce the Image, in whole or in part, individually or in conjunction with other images, printed or electronic matter, in any media now or hereafter known, for educational, promotional, or marketing purposes or any other legitimate purpose whatsoever, and to use my name in connection therewith if Georgia Tech and/or GTRC so chooses. I also hereby grant Georgia Tech and GTRC the right and permission to alter, transpose and/or edit images, videotapes, recordings or other media featuring the Image to the extent necessary to use, display, publish, post or reproduce the Image, in whole or in part, in any media or format, now or hereafter known, and/or on the World Wide Web or in any other manner. I hereby waive any right to inspect or approve Georgia Tech or GTRC’s use of the Image or any finished version or display incorporating the same.

3. As part of my participation in the Activity, Georgia Tech or GTRC may display, publish or post the Image on the World Wide Web or another widely accessible manner. I understand that the Image shall be readily accessible by the general public. I acknowledge and agree that Georgia Tech, The Board of Regents of the University System of Georgia (“Board of Regents”), GTRC and their members, officers and employees individually shall not be responsible for any use of the Image by any third party accessing the Image through the World Wide Web or any other manner.

4. I hereby release and forever discharge Georgia Tech, The Board of Regents, GTRC, and their members, officers and employees individually from all claims, demands, rights, and causes of action of whatever kind, arising from and by reason of any known or unknown, foreseen or unforeseen injuries, damages, and the results thereof resulting from the use of the Image, including without limitation, claims of slander, libel, invasion of privacy, or rights of publicity. I understand that the acceptance of the release and waiver of liability herein by Georgia Tech and The Board of Regents shall not constitute a waiver, in whole or in part, of sovereign immunity by Georgia Tech, The Board of Regents, and their members, officers, and employees individually.

5. This license and release shall inure to the benefit of the heirs, legal representatives, licensees and assigns of Georgia Tech, Board of Regents, and GTRC. This release shall be binding upon me and my heirs, legal representatives and assigns.

6. If any provision of this authorization and release shall be held invalid or unenforceable, such provision will be deemed deleted from this authorization and release without invalidating the remaining provisions of this authorization and release or affecting the validity or enforceability of such remaining provisions.