Sports Media Profile & Release Form

Sports Media Profile & Release Form

(please complete thoroughly, as this will serve as the basis for your website profile)
Student-Athlete Information

Let's Start with the Basics
Student-Athlete Legal Name

First NameLast Name
Pronunciation of Your Full Name
ex: Corey Graham (Cor-ee Gram)
Student-Athlete Cell Number

Country CodeArea CodePhone Number
Student-Athlete Email
example@example.com
Student-Athlete Date of Birth

MonthDayYear
Date
VU Primary Sport
VU Secondary Sport (if applicable)
Head Coach Email
Year of Eligibility
Height
Weight
male athletes only
Position or Events
Academic Major
if none, write 'undecided'
High School
Year of High School Graduation
Previous School
transfers only
Hometown
city/state/country
Athletic Background

Tell Us About Your Athletic Journey
Sport(s) Participated in High School
Club, AAU Team/City
Club, AAU Team Coach
List any individual or team honors/awards from your high school/previous school athletic career. (i.e. first team all-state, team captain senior year, school records held, player of the year, won state championship sophomore year, etc.)
Family & Personal Background

Help Us Get to Know You Beyond Athletics
Parent/Guardian Names
complete how you would prefer them listed
Parent/Guardian’s Alma Maters
include any sports played
Names of Siblings
if applicable
List any relatives that currently or previously have played any college or professional sports. Please also include what team they played for.
List any high school or college activities/organizations you are/were involved with outside of athletics.
Social Media & Media Information

Help Us Share Your Story Throughout the Year
Tik Tok Handle
Instagram Handle
X (Twitter) Handle
X (Twitter) Handle
Permission to Mention/Tag
List any hometown newspapers, TV, or radio shows that you would like to receive news about your athletic career at VU (name & location).
Favorites & Fun Facts

Help Us Get to Know the Real You
Nickname
Favorite Food
Favorite Midnight Snack
Favorite TV Show
Favorite Movie
Favorite Song
Favorite Music Type or Artist
Favorite Book
Favorite Athlete
Favorite Sport to Watch
Favorite Class at VU
Hobby
Dream Car
Car I Actually Drive
Favorite Vacation
Country I'd Like to Visit
Biggest Pet Peeve
Favorite Saying
Superstitions
Goals & Motivation

Tell Us What Drives You
Career Plans
Dream Job
Season Goals for the Team
Season Goals for Myself
What Motivates Me
The Best Advice I Was Ever Given
One Thing I Wish I Was Better At
My Advice to Kids
Your Story

Tell Us What Makes Your Journey Unique
I Chose VU Because...
The Most Memorable Moment in My Athletic Career Was...
Why I Wear the Number I Have
if applicable
Since I've Been at VU, I've Learned...
The Best Thing About Being a VU Athlete Is...
If I Were Coach for a Day, I Would...
If I Could Attend Any Sporting Event, It Would Be...
If I Could Break Any Record, It Would Be (does not have to relate to your sport)...
Person I Would Trade Places With for a Day & Why
Person in History I Would Like to Meet & Why
Nobody Knows How Much I...
When People First Meet Me, They Think...
A Book/Movie About My Life Would Be Titled...
Is there anything else specifically you would like to see in your bio?
Authorization
I hereby authorize Vincennes University to release my intercollegiate participatory sports records to media outlets requesting such information for publication or other use. The released information may include the following: actual game statistics, pertinent personal data such as height, weight, position, age, hometown, college class status and past schools attended, comments for use in feature articles and photographs, films, drawings or slides, pertinent medical information in consultation with the head athletic trainer, doctor or coach. This information may also include records earlier forwarded to Vincennes University from high school and other colleges attended by me. Excluded from this information for release are any other academic records other than those of a positive nature such as for promotion with the mass media for conference or national athletic academic honors. Your grade point average may be used to highlight your achievement in print or online.
I hereby authorize Vincennes University absolute right and permission to reproduce, use, exhibit, display, broadcast, distribute, and create derivative works of University-related photographs, videotaped images, voice recordings, and name of the undersigned person, in whole, in part, of in composite, for use in connection with the activities of the University or for promoting, publicizing or explaining the University or its activities.
I hereby authorize Vincennes University use of my image and/or likeness for promotional purposes with my consent. This authorization includes, without limitation, the right to publish such images in the University Web site, alumni magazine, and PR/promotional materials, such as marketing and admissions publications, advertisements, fund-raising materials, and any other University-related publication. These images may appear in any of the wide variety of formats and media now available to the University and that may be available in the future, including but not limited to print, broadcast, videotape, CD-ROM, DVD, and electronic/online media. I hereby waive any right that I may have to inspect or approve the finished product or products or the advertising copy or printed matter that may be used in connection therewith or the use to which it may be applied.
I hereby release, defend, indemnify and hold harmless Vincennes University Department of Athletics, its Trustees, officers, employees, and agents from and against any claims, damages or liability arising from or related to the use of the images, recordings or materials, including but not limited to claims of defamation, invasion of privacy, or rights of publicity or copyright infringement, or any misuse, distortion, blurring, alteration, optical illusion or use in composite form that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution.
I hereby authorize that I have read this document before signing below, and I fully understand the contents, meaning and impact of this consent, waiver, indemnity and release. This consent, waiver, indemnity and release is binding on me, my heirs, executors, administrators and assigns.
Student-Athlete Legal Name

First NameLast Name
Student-Athlete Student Number
ex. A00123456
Student-Athlete Date of Birth

MonthDayYear
Date
Student-Athlete Cell Number

Country CodeArea CodePhone Number
Student-Athlete Email
example@example.com
Head Coach Email
Primary Sport
Student-Athlete Signature
Date

MonthDayYear
Date
Parent/Legal Guardian Signature

(required if student-athlete is under 18)
Date

MonthDayYear
Date
Should be Empty:

Sports Media Profile & Release Form

Student-Athlete Information

Athletic Background

Family & Personal Background

Social Media & Media Information

Favorites & Fun Facts

Goals & Motivation

Your Story

Authorization