Photo Release Form

I, the undersigned, do hereby consent and agree that The Lane-Scott Electric Cooperative, Inc., its employees, successors, agents or assigns (“Lane-Scott”) have the right to take photographs, videotape, digital recordings, or use my voice, likeness, name, testimonial statements and other recordings of me (collectively “Likeness”) to use these in any and all media. I agree that Lane-Scott may use my Likeliness with or without my name for any lawful purpose, including for but not limited to publicity, illustration, advertising, web content, social media content and the Kansas Country Living magazine. I understand that I am not entitled to and will not be compensated for or receive any other remuneration for the recording or use of my Likeness. I further understand that I have no rights in the media my Likeness is used in or rights to review or approve any media use or any edits to Likeness prior to its use. I understand I am not permitted to use or download the media which incorporates my Likenesses from the intranet for non-business purposes. I hereby hold harmless, release and forever discharge Lane-Scott its officers, employees and agents, from any and all claims, demands, or other actions and liability arising out of or in connection with the use of my Likeness or the media it is used in, including without limitation any and all claims for defamation, right of publicity, or invasion of privacy regardless of any adverse result to me. I HAVE READ THIS RELEASE AND FULLY UNDERSTAND THE CONTENTS OF IT. THIS RELEASE SHALL BE BINDING UPON ME AND MY HEIRS, LEGAL REPRESENTATIVES, AND ASSIGNS. THIS AUTHORIZATION AND RELEASE SHALL ALSO INURE TO THE BENEFIT OF THE HEIRS, LEGAL REPRESENTATIVES, LICENSEES, AND ASSIGNS OF LANE-SCOTT.