I hereby consent to and authorize the use of my video recorded and/or photographed image and/or likeness by the IEP Techncial Assistance Center (IEPTA). It is understood that my image will become a part of a video and/or printed work produced by IEPTA. I release IEPTA, their agents, and assigns from any and all liability, including, but not limited to, claims for libel, right of privacy, or right of publicity that I now possess or may later acquire, resulting from the production, reproduction, distribution, marketing, or use of the image by IEPTA.

I understand that I will not be separately compensated by IEPTA for my participation in the activities recorded in these materials or for IEPTA’s use of these materials. IEPTA agrees to take reasonable steps to preserve the integrity of these materials and their use, but I understand that IEPTA cannot be and is not responsible for unlawful use of the materials by third parties not affiliated with IEPTA. I am over eighteen (18) years of age and competent to execute this Release and Authorization. At any event where video/audio recording is implemented, an attempt to designate seating areas for people who do not wish to be recorded will be made.