Photo and Video Release

Legal Name *

Legal First NameLegal Last Name

Preferred First Name

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Hometown*

Program of study*

Name of academic program at STC.

Permission to Use Photographs or Video Images

I hereby authorize Southeast Technical College to photograph me and/or my property and assign the absolute right and unrestricted permission to copyright, publish and/or use such photographs/videotaped images or statements, in whole, in part, or in composite form (including use with and without my name) made through its studios or elsewhere, for art, advertising, trade or any other lawful purpose.

I hereby release, discharge and agree to hold harmless Southeast Technical College, its nominees or others for whom Southeast Tech is acting, from any liability by virtue of any use whatsoever, whether intentional or otherwise, that may occur or be produced in the taking of said photograph or videotape, or in any processing tending toward the completion of the finished product.

Please check the following:*

I understand that I will not receive any monetary compensation for the use of my photograph(s)/video image(s).I understand STC has the right to edit, alter, copy, or distribute the photograph(s)/video image(s) for any lawful purpose and the right to use my name in connection with the photograph(s)/video image(s) if they choose.I waive any right that I may have to inspect and approve the finished product, or the advertising copy that may be used in connection therewith, or the use to which it may be applied.

Signature

By signing below, I acknowledge that I have read and understood this Permission to Use Photo Release Form and agree to the terms and conditions stated above.

Signature*

Date signed

MonthDayYear