Photograph and Publicity Consent Release Form
I, _____, give the AmeriCorps Nonviolence KOPS Program and its fiscal agent, the Michigan Institute for Nonviolence Education (MINE), permission to use my name, likeness, image, voice, and/or appearance as such may be embodied in any pictures, photos, video recordings, audiotapes, digital images, and the like, taken or made on behalf of the KOPS Program or MINE activities. ................
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