I hereby authorize Midstates Bank, and its affiliates, officers, agents, and employees, to publish, distribute, or otherwise display my image, physical likeness, and/or voice, in photographic, video, audio, or electronic reproduction form, in any materials and on websites for promotional, marketing, advertising, fundraising, program promotion or other activities relating to Midstates Bank, whether now or in the future.
I agree that I will make no monetary or other claim against Midstates Bank for the use of my image, physical likeness, and/or voice, and waive any right to inspect or approve the finished product where my image, physical likeness, and/or voice appears. I hereby release and agree to indemnify and hold harmless Midstates Bank and its affiliates, officers, agents, and employees pertaining to any cause of action arising out of the use, reproduction, distribution etc. of my image, physical likeness, and/or voice.
I understand that Midstates Bank shall be the exclusive owner of all right, title, and interest in and to the copyright pertaining to its use, reproduction, distribution etc. of my image, physical likeness, and/or voice. I certify that I am at least 18 years of age (or if under 18 years of age, that I am joined by my parent or legal guardian). I have read the authorization and release information and give my consent for the use as indicated above.