Photo, Video, and Media Consent Release Form
I give the American Indian College Fund permission to use my photographs, videos, quotes, and likeness for print and electronic fundraising, public education, media publication, and marketing purposes in any and all manner, including with third party organizations that support the College Fund, for promotion of Native higher education and scholarship support, in perpetuity. For use with a minor child: I give the American Indian College Fund permission to use my child’s photographs, videos, quotes, and likeness for print and electronic fundraising, public education, media publication, and marketing purposes in any and all manner, including with third party partners for promotion of Native higher education and scholarship support, in perpetuity.
Name
*
First
Last
Minor's Name (if applicable)
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
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Additional Notes
Feel free to share details about your submission (is this part of a specific project or intended recipient at the College Fund?)
Signature
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