Quote, Photography and Video Release Form

The signature of the parent/legal guardian operates as an acceptance of the terms and conditions of this form on behalf of a minor child and for themselves.

I hereby irrevocably grant and authorize Massachusetts Higher Education Assistance Corporation d/b/a American Student Assistance (hereinafter referred to as ASA), its photographers, videographers, representatives, agents, employees, directors, contractors, subsidiaries, and assignees to:

· The unrestricted right and permission to copyright and use, reuse, publish, and republish photographic portraits, pictures and video recordings in which I may be included intact or in part, composite or distorted in character or form, without restriction as to changes or transformations in conjunction with my own or a fictitious name, or reproduction hereof in color or otherwise, made through any and all media now or hereafter known for any purpose whatsoever. ASA shall own any and all rights to such images and video recordings in any form and in any media.

· The unrestricted right and permission to use my name, comments, and demographic information such as age, hometown and/or college in materials for internal and external audiences.

· I waive any right to royalties or other compensation arising or related to the use of such information, comments, photographic portraits, pictures or video recordings.

· I hereby relinquish any right that I may have to examine or approve the completed product or products or the advertising copy or printed matter that ASA may apply and for which ASA may use for any purpose.

· I hereby release, discharge, and agree to save harmless ASA, its representatives, directors, employees, officers, contractors, subsidiaries, assigns and all persons functioning under ASA’s permission or authority, or those for whom ASA is functioning from any liability by virtue of any editing, blurring, distortion, alteration, optical illusion, or use in composite form whether intentional or otherwise, that may occur or be produced in the taking of said picture or recording of said video or in any subsequent processing thereof, as well as any publication thereof, including without limitation any claims for libel or invasion of privacy, any claims of defamation, infringement of moral rights, rights of publicity and/or copyright.

· I waive any protection that may be afforded by any statute or law in any jurisdiction whose purpose, substance and/or effect is to provide that a general release shall not extend to claims, material or otherwise, which I do not know of or suspect to exist at the time of executing this document.

I hereby affirm that I am 18 years of age or older and have the right and authority to contract in my own name or that I am the parent or legal guardian of the below named student and I have authority to contract in his/ her name. I have read the above release prior to its execution and fully understand the contents thereof. I am executing this release under my own free will under no force of threat or duress. This release is binding upon me and my heirs, legal representatives, and assigns.

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Signature Parent’s/Legal Guardian’s Signature

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Printed Name Printed Name

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Date Date