> As used below, "NASA" shall mean National Aeronautics and Space
> Administration, and its officers, directors, employees, agents and
> assigns.
>
> I (the undersigned) am informed that NASA will be (or has been)
> filming material and that NASA has requested that I grant it the right
> to photograph me, and record my voice and likeness during the
> event(s).

I do hereby confirm the consent heretofore given NASA with respect to
NASA photographing me in connection with the Program, and I do hereby
grant to NASA, its successors and licensees, the right to use,
reproduce, distribute to the public, perform publicly and display
publicly, the films/tapes/recordings containing my voice and/or likeness
and any and all revisions and reproductions thereof, in any and all
media without limitation, throughout the world, and NASA shall have the
right to authorize and license others to do so. I agree that NASA may
record all of said photographs on tape, film or otherwise and use said
photographs and recordings, including the use of my voice and likeness
therein contained, in connection with the Program, for advertising,
promotion, exploitation, and any other use in connection with the
Program as NASA may desire throughout the world and in perpetuity in any
and all media now known or hereafter devised. NASA may use my name,
voice and likeness and other information concerning me in connection
with the Program at NASA's sole discretion.

I expressly acknowledge that NASA has no obligation to use my voice,
likeness or name in connection with the Program and further acknowledge
that NASA may delete, edit, change, and/or rearrange all or any of the
foregoing. I acknowledge that any opinion expressed by me during filming
is my own, and not the opinion of NASA. I further agree that the
statements made by me in my interview are true and correct to the best
of my knowledge.

I hereby unconditionally release NASA from and against any and all
claims, liabilities, demands, actions, causes of action, costs and
expenses, whatsoever, at law or in equity, known or unknown, anticipated
or unanticipated, suspected or unsuspected, which I ever had, now have,
or may, shall, or hereafter have by any reason, matter, cause or thing
whatsoever, arising out of my performances, your photographing me, the
broadcast or use of such photographs or recordings, or otherwise in
connection with the Program.

**I represent that I am at least eighteen (18) years of age.**

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Signature Date

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Name (Please Print)

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Address (Street, City, State, Zip) Telephone

**If participant is under 18 years of age:**

I represent and warrant that I am the parent or guardian of the
above-signed minor ("Minor"). I have read the foregoing agreement and am
familiar with all of the terms and conditions thereof and I consent to
its execution by the Minor. I agree that neither the Minor nor I will
revoke or disaffirm the foregoing agreement at any time.

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Signature of Parent/Guardian Name (Please Print)