By completing this form, you agree that Wilfrid Laurier University may use name, likeness and/or biographical information provided. You also release and forever discharge Wilfrid Laurier University, its agents, officers and employees from any and all claims and demands arising out of or in connection with the use of said images or biographical information, including but not limited to, any claims for invasion of privacy or defamation.
The information you provide in this form will be kept on record until April 2019.
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