I hereby grant Cultural Vistas, Inc. ("Cultural Vistas") the right to use, reproduce, publish, and create derivative works of my submission, including any words, images (still or moving), sounds, and likeness in connection with related marketing and public information programs and activities.
Additionally, I hereby authorize Cultural Vistas to release, publish, or quote such material, including my name, in connection with related marketing and public information programs and activities. With respect to this material, I understand that content may be included in various outlets, on the Internet, and through multiple broadcast channels and print media. I understand that I may decline to give my consent (by not signing this Form) and still continue to participate in all exchange program activities without being disadvantaged with respect to those activities.