General Waiver and Permission

I permit the University of Michigan (U-M) to create materials (such as photographs, videotape, film, audio recordings, web-casts or cable-casts, or any other medium) to capture, record, otherwise document me (i.e. my image, voice, likeness, and my participation) or my works of authorship in programs and activities at the U-M Penny W. Stamps School of Art & Design.

If U-M determines that education or research may benefit from the use of these materials, including any materials already in its possession, U-M may publish the materials for academic purposes or use them in any other professional manner that U-M believes is proper. I understand and agree that U-M has my permission to use, copy, distribute, publicly perform or display, and make derivative works of materials that include me and/or my works of authorship. I understand that I will not receive payment or any other compensation in connection with the use of these materials.

While I am aware that U-M endeavors to use only current materials, I understand that U-M may use my materials as long as I am an enrolled student and thereafter.

I have had a chance to discuss this release form with the Penny W. Stamps School of Art & Design staff and have received complete answers to all of my questions.

I release the U-M from any and all liability that may or could arise from use of materials that include me and/or my works of authorship.

Release *

I agree to the terms of this General Waiver and Permission I do not agree to the terms of this General Waiver and Permission

Name *

First Name Last Name

Uniqname *

Enter your U-M uniqname (this is the first part of your U-M email address)

UMID *

Enter your 8-digit UMID number.

Signature *