RELEASE STATEMENT

I do hereby give, donate, and convey to the Blavatnik Archive Foundation (the “Archive”) the following materials for its Archive (hereinafter referred to as the “Donated Materials”).

I authorize the Archive to use the Donated Materials for educational purposes, allowing access to researchers, and for use in educational projects including virtual and physical exhibits, print and digital production, and to be made available via physical and internet platforms.

I have the right to give this permission to reproduce and distribute the Donated Materials.

Name *
Name
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Date
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Printed copy only