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Future Leaders Program Media Release Form
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Release Form for Media Recording

I consent and agree that The Chicago Network, its employees, or agents have the right to take photographs, videotape, or digital recordings of me to use in any and all media. I further agree that my name and identity may be revealed therein or by descriptive text or commentary.

I release to The Chicago Network, its agents, and employees all rights to exhibit the work in print and electronic form.

I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used. I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback.

I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement.