Media Disclaimer: I hereby consent and authorize a staff member or volunteer of Sacramento Pagan Pride to take photographs or motion pictures of me; or to produce videotapes, audiotapes, closed circuit television programs, web casts, or other types of media productions that capture my name, voice, and/or image (any of the foregoing types of media are called the “Materials” in this Consent and Release form). I authorize Sacramento Pagan Pride to copyright the Materials, and I authorize Sacramento Pagan Pride to use, reuse, copy, publish, display, exhibit, reproduce, license to third party, and distribute the Materials in any educational or promotional materials or other forms of media, which may include, but are not limited to university publications, catalogs, articles, magazines, recruiting brochures, websites or publications, electronic or otherwise, without notifying me. I also agree that Sacramento Pagan Pride may identify me by name, services/items offered, and such other identifying information as modality, hometown, etc. (unless stated otherwise below) I agree that I am participating on a voluntary basis and I will not receive any payment from Sacramento Pagan Pride for signing this release or as a result of any publication of the Materials. I represent that I am at least 21 years of age, or if not, that I have secured the signature of my parent or legal guardian. *