Personal Information

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* First name

* Last name

* Email address

* Media ReleaseThis question is required.

I do hereby irrevocably grant the Federal Reserve Bank of Cleveland (the “Bank”) permission to have film, videotape, photographic, digital, and other images taken of me, and to use, display, publish, broadcast, and distribute for education or other purpose, separately or together, my name, videotaped, photographic, digital and/or other images of me, and to modify, edit, or combine the same in any present or future publication(s), broadcast(s) and exhibit(s), without geographic or time limitation. Further, I irrevocably grant the Bank permission to record my spoken words and to use, play, publish, broadcast, and distribute the audio portion embodied on any film, videotape, disc, or other recording made of my spoken words, for education or other purpose, and to modify, edit, or combine the same in any present or future recording(s), broadcast(s), and exhibits(s) in any media, without geographic or time limitation. I understand that the Bank owns all rights to the aforementioned images and recordings. I agree this authorization is given without promise of compensation. I waive all rights in the images and recordings and release the Bank, its agents, officers and employees from any loss, damage, and/or liability arising out of my appearance on such images and recordings.