Authorization for Limited Release and Use of Information

I, (the releasor), hereby authorize the Richard M. Schulze Family Foundation (the Foundation) to use information specified herein in any Foundation publication, including its website.

This authorization includes the following provisions:

A.  Releasor hereby authorizes the Foundation to use Releasor’s image in a photograph, video, or other digital media, in any and all of the Foundation’s publications, including print or web-based publications. For purposes of this release, an “image” includes those that are supplied to the Foundation by the Releasor, or that originate at any Foundation sponsored event.

B.  Releaser hereby authorizes the Foundation to publish his/her name, image, class year, information on high school performance and recommendations, hometown, and college attendance information in any Foundation publications, including its website.

C.  Releasor authorizes the Foundation to copy, edit, enhance, crop, or otherwise alter any image of Releasor for use in the Foundation’s publications. Releasor also waives any rights for approval or inspection of any image used in the Foundation’s publications.

D.  The Foundation agrees that it shall not use any information not specified in this authorization in any of its publications without the express consent, received verbally or in writing, of the Releasor.

E.  The Foundation represents that it will not publish any personal contact information of the Releasor in any format, without the express, written consent of the Releasor.

F.  Releasor agrees that this authorization shall be valid and effective for five years following the date of signing this release.

G.  Releasor agrees to release and forever discharge the Foundation, its successors and assigns, officers, employees, representatives, partners, agents and anyone claiming through them, in their individual and/or corporate capacities from any and all claims, liabilities, obligations, promises, agreements, disputes, demands, damages, causes of action of any nature or kind, known or unknown, which Releasor, and anyone claiming on behalf of Releasor, may have or claim to have against the Foundation in connection with this Release.

H.  Releasor represents the (s)he has the authority and ability to agree to all the terms of this release.

I.  Releasor represents to have carefully read and fully understand all the provisions of this authorization. Releasor further represents that (s)he has agreed to these provisions freely and voluntarily; that no part of any award, scholarship, grant, or other monetary distribution from the Foundation to be received by the Releasor was reliant on agreement with these provisions; and that Releasor is not entitled to any compensation or royalties with respect to the Foundation’s use of any images or information.

J.  The terms of this Release shall be governed by and construed in accordance with the laws of the state of Minnesota.

A .pdf version of the Authorization for Limited Release and Use of Information can be found here.