Statement of Acknowledgement:

I certify that this information is true and complete to the best of my knowledge. If this application leads to appointment, I understand that false or misleading information in my application or ambassador activities may result in my release.

Alumni Ambassador Photography Release Form: I hereby grant to Cultural Experiences Abroad, Inc. ("CEA CAPA") the absolute and irrevocable right and unrestricted permission to edit, alter, copy, exhibit, publish, distribute and otherwise use any photographs taken by me in connection with my role as an Alumni Ambassador under the CEA CAPA Alumni Ambassador Program (the "Recorded Materials"), including without limitation, any written content, quote, recording of my voice and or other digital reproduction of me or other reproductions of my physical likeness, for any publication processes, whether electronic, print (bulletins, brochures, newsletters, ads, etc...), digital or electronic publishing online, for purposes of publicizing CEA programs or any other lawful purpose. By submitting such Recorded Materials to CEA CAPA, I hereby represent and warrant that such Recorded Materials are original works or authorship created solely by me. To the extent any Recorded Materials are submitted by me to CEA CAPA, I agree to indemnify, defend and hold harmless CEA CAPA from any third party claims that such materials infringe the intellectual property rights, privacy rights or any other rights of a third party. I understand and agree that the Recorded Materials will become the property of CEA CAPA. Additionally, I waive the right to inspect or approve any finished product, including written or electronic copy, wherein any Recorded Materials or my likeness appears and hereby hold harmless and release and forever discharge CEA CAPA from all claims which I, my heirs, representatives, executors, administrators or any other persons acting on my behalf or on the behalf of my estate have or may have by reason of this authorization. I understand that the term "photograph" as used herein encompasses both still photographs and motion picture footage (whether recorded on film, video, digital or any other media).