RELEASE AND HOLD HARMLESS AGREEMENT

INSTRUCTIONS

Use the Release & Hold Harmless Agreement to obtain permission from individuals to use their image or visual likeness, their name, and/or their voice in any Midland States Bank publications or other productions. If this Release is being granted with respect to a minor, it is necessary to first obtain the prior consent of the minor’s parent(s) or legal guardian(s). NOTE: Each individual must sign a separate Agreement (Adults and Minors).

AGREEMENT & RELEASE

I, the undersigned, hereby grant Midland States Bank (“Midland”) irrevocable permission to use, adapt, modify, reproduce, distribute, publicly perform and display, in any form now known or later developed, my image or visual likeness, portrait, photograph, my name and/or my voice (the “Personal Information”) as specified in this Release and indicated above, throughout the world, by incorporating it or them into publications, catalogues, brochures, books, magazines, photo exhibits, motion picture films, internet websites and posts, videotapes, and/or other media (the “Works”) or commercial, informational, educational, advertising, or promotional materials relating thereto.

I release, and hereby agree to indemnify, defend, and hold harmless Midland, its agents, employees, licensees and assigns (collectively, “Released Entities”) from any and all claims I, or any third party, may have now or in the future for invasion of privacy, right of publicity, copyright infringement, defamation or any other cause of action arising out of the use, exploitation, reproduction, adaptation, distribution, broadcast, performance or display of the Personal Information.

I waive any right to inspect or to approve any Works that may be created using the Personal Information and waive any claim with respect to the eventual use to which the Personal Information may be applied. The Personal Information may be used at Midland’s sole discretion, with our without notice, with or without my name or with a fictitious name, and with fictitious or accurate biographical material, alone or in conjunction with any other material of any kind or nature except that Midland will not use the Personal Information for any criminal or illegal purposes or in a manner inconsistent with community standards of decency.

I understand and agree that Midland is and shall be the exclusive owner of all right, title, and interest, including copyright, in the Works, and any commercial, informational, educational, advertising, or promotional materials containing the Materials. I further understand and agree that Midland does not owe me any compensation for the acts to which I have consented to in this Release.

I am of full legal age and have read this release and am fully familiar with its contents.