Photo and Video Release Form

I hereby grant to The University of Texas at Brownsville and its representatives, employees, agents and assigns the irrevocable and unrestricted right to use, reproduce and publish photographs and/or videos of me, including my image and likeness as depicted therein, which are identified in Appendix A* hereto, for editorial, trade, advertising or any other purpose and in any manner and medium, and to alter the same without restriction and to copyright the same. I hereby release The University of Texas at Brownsville and its trustees, officers, employees, agents, legal representatives and assigns from any and all claims, actions and liability relating to its use of said photographs and/or videos.

IN WITNESS WHEREOF, the undersigned, intending to be legally bound hereby sets their hand and seal the date