Media Release Form

I grant permission to Central Lakes College (“College”) and its agents or employees, to use photograph, record, film and electronically capture in permanent form my name, likeness, image, voice, appearance and/or performance, that will or occurred on the following date entered below (hereinafter “Recording”). I grant to the College, without limitation, the right to edit, mix or duplicate and use or re-use Recording in whole or in parts as it may elect. College, and those acting on its behalf, may use and redistribute the Recording for marketing purposes.

I hereby waive any right to inspect or approve the Recording, derivative works or any written materials associated with them. I understand that the Recording and copyright will be the sole property of the College.

I hereby agree to release and hold harmless the College and its agents or employees, including any organization publishing and/or distributing the Recording in whole or in part, whether on hard copy or through electronic media, or another media, from and against any claims, damages or liability arising from or related to the use or misuse of the Recording including but not limited to any alteration or use in composite form, either intentionally or otherwise, that may occur at any time.

I am 18 years of age or older and I am competent to contract in my own name. I have read this consent/release form and I fully understand the contents, meaning and impact of it. I hereby accept the terms of this consent/release by submitting this form.