Photo Release Form

TRIO Photo Release Form

In consideration for my participation in TRIO programs and events, I hereby consent and agree that Iowa State University; the Board of Regents, State of Iowa; their officers, servants, agents or employees (hereinafter referred to as RELEASEES) may use, reuse, publish and republish my picture or likeness and/or recording of my voice in whole or in part, individually or in conjunction with other photographs or recordings from the production by Iowa State University TRIO programs, in any manner or form, in any medium for any legitimate purpose, and at any time or place so desired.

I release and discharge RELEASEES from any liability I may have arising from any alteration that may occur in the marketing and editing of said production. Furthermore, I agree to indemnify and hold RELEASEES harmless from any liability arising from the use or dissemination of said production due to anything I may have said or communicated in the same. I agree that I am to receive no further consideration other than that already received for any further or future uses by said RELEASEES.

I intend for this agreement to be binding on my heirs, successors, and assigns, and it represents the entire agreement between the RELEASEES and me regarding the matters herein agreed. In the instance that I am under the age of 18 my guardian will co-sign below.

I agree to photo authorization and release.
YesNo

Are you over or under age 18?
Over 18Under 18

What is the participant's birthdate?

If under 18 include guardian name and email.

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