PHOTO RELEASE

This Photo Release is given on today’s date to the University of Central Arkansas (“UCA”).

For purposes of this Agreement, the term “UCA” shall refer to and mean the University of Central Arkansas, the President of UCA, any past, present and future members of the UCA Board of Trustees, any employee, representative or agent of UCA, and any entity associated with, or controlled by, UCA.

I hereby grant permission to UCA the right to reproduce, use, exhibit, display, broadcast, distribute, and create derivative works of photographs or videos containing the image/likeness of me or my child. I understand these images and other personally identifiable information may be used for promotional, news, research, and educational purposes.

For myself, my child and other children, and all of my heirs, personal representatives, successors and assigns, or any other persons claiming by or through me, I do hereby forever waive, release and relinquish any and all claims, demands, causes of action, liabilities, costs or expenses (including, but not limited to, attorneys’ fees) (all of the foregoing being referred to collectively as “Claims”), against UCA which are associated with, or arise out of or in any manner are related to, anything contained in the photographs or videos. The waiver and release set forth herein waives and releases any and all Claims under any federal or state law, as well as any common law cause of action, whether in contract, tort or any other legal theory.

By checking the box, I am agreeing to these terms and conditions. Before I agreed to these terms, I read through all of the terms. I have agreed freely and voluntarily and certify that I am at least 18 years of age.

UNIVERSITY LIABILITY RELEASE FORM

If you need to use the Health Services facility while on the University of Central Arkansas Campus you will need to fill out a Medical History and Consent for Treatment Form. You will be able to obtain this form from your Camp Director or the Area of Scheduling and Events Office in the Brewer-Hegeman Conference Center.

AGREEMENT FOR ASSUMPTION OF RISK & RELEASE INDIVIDUAL PARTICIPANT RELEASE

I, being allowed to use the facilities of the University of Central Arkansas (hereinafter “University”) for Makerspace activities do hereby release & forever discharge the University, & all of its officers, agents, employees, trustees, &/or successors in interest, from & against any & all claims of damages, demands, & actions, or causes of action, on account of damage to personal property, personal injury, or death which may result from my participation.

Specifically, I release the University, & all of its officers, agents, employees, trustees, &/or successors in interest from any claim against them, which relates to my participation in activities related to the event while on the campus of the University. I acknowledge for myself that I am the recipient of a privilege from the University. I understand that privilege is a tangible benefit to me. I also fully understand that my participation in activities related to the event at the University is voluntary & that I am not required to participate. I hereby attest & verify for myself that I have full knowledge of the risks involved in participation in the event at the University & assume those risks, & will assume & pay my own medical expenses & emergency expenses in the event of an accident, illness, or other incapacity. I attest that I am physically fit & sufficiently trained to participate in the event at the University. Should injury or illness occur while on campus, I give my permission to receive treatment, if necessary, from UCA Student Health Services &/or a local Conway health-care provider at my expense.

I, for myself, accept full responsibility for any use of all facilities, including property of the University; & agree to make full restitution with regard to any compensation required as a result of my participation or use, misuse, damage, or negligence to such properties. It is my express intent that this Agreement for Assumption of Risk & Release shall bind the members of my family & spouse, if I am alive, & my heirs, assigns or personal representatives, if I am deceased, & shall be deemed as a RELEASE, WAIVER, DISCHARGE & COVENANT NOT TO INSTITUTE LEGAL ACTION AGAINST THE ABOVE-NAMED RELEASEES. I HEREBY

FURTHER AGREE THAT THIS RELEASE SHALL BE CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF ARKANSAS. I further hereby agree to indemnify & hold harmless the releasees from any loss, liability, damage or costs, including court costs & attorney’s fees, that they may incur due to my participation in said activity, whether caused by negligence of releasees or otherwise. In agreeing to these terms for Assumption of Risk & Release, I acknowledge & represent that I have read the foregoing & freely & voluntarily agree to its terms. I further acknowledge that no oral representations, statements or inducements, apart from the foregoing terms Agreement, have been made, & that I am at least eighteen (18) years of age & fully competent.

I, parent or legal guardian of my child acknowledge & represent that I have read the foregoing Agreement for Assumption of Risk & Release, & that I understand & agree to it on behalf of my minor son/daughter, voluntarily as my own free act & deed. I further acknowledge that no oral representations, statements or inducements, apart from the foregoing terms Agreement, have been made. It is my express intent that this Agreement for Assumption of Risk & Release shall bind the members of my family & spouse, if I am alive, & my

heirs, assigns or personal representatives, if I am deceased, & shall be deemed as a RELEASE, WAIVER, DISCHARGE & COVENANT NOT TO INSTITUTE LEGAL ACTION AGAINST RELEASEES NAMED IN THE AGREEMENT FOR ASSUMPTION OF RISK & RELEASE ATTACHED HERETO. I HEREBY FURTHER AGREE THAT THIS RELEASE SHALL BE CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF ARKANSAS.

In witness whereof, I have caused this Release of Parent or Legal Guardian for Minor to be executed.