In accordance with the Family Educational Rights and Privacy Act, I, the undersigned, hereby authorize the faculty athletics representative, athletics director and registrar of the institution I am attending to release any and all information about me which pertains to my eligibility to participate in intercollegiate athletics.
The release of such information shall be restricted to any and all official representatives of the National Association of Intercollegiate Athletics (NAIA), and the conference and its member representatives.
Such information is to be released only for the purpose of determining my eligibility for intercollegiate athletics, or for research or analytical purposes regarding student-athlete eligibility, academic progress or institutional administration of athletics.
It is further understood that I may receive copies of such material from the institution upon request.