College of Education and Human Development

Marketing and Promotion Release Form

Photos may be used in brochures, handbooks, displays; Photos/Videos may also be used in advertising including media stories, TV and newspaper. Photos/Video used for the Internet will not identify any individual under the age of 18.

First Name (required)

Last Name (required)

Are you under 18 years old? (required)

Yes

Parent/Guardian Information

First Name

Last Name

Address

address, city, state, zip

Phone

Certify (required)

I hereby give Western Michigan University and the College of Education and Human Development the absolute right and permission to copyright and/or publish video images or pictures of me, which may be included in whole or part, for news release, art, advertising, trade, or any other lawful purpose whatsoever. I hereby waive any right to inspect and/or approve the finished product or the advertising copy that may be used in connection therewith, or the use to which it may be applied. I hereby release, discharge, and agree to save Western Michigan University and from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the making of said pictures, or in any processing tending towards the completion of the finished product.

Yes