Office of Precollege Programming
Western Michigan University
Kalamazoo MI 49008-5288 USA
(269) 387-2773
Photo Release Form
Media, Photo & Video Release Form
Purpose of this Form
Western Michigan University’s (51¸ŁŔűÉç) Academically Talented Youth Program (ATYP) is committed to protecting the privacy of students.
Authorization
By signing this form, you will be authorizing the following:
I understand that during the course of my child’s participation in the above-referenced activity (the "Program"), that the Program and/or those acting with the Program’s permission or authority, may capture my child’s name, likeness, image, or voice in photographic, audio, video, digital or other recording forms (“Recordings”). I give my permission for the Program to use those recordings or works produced by my child (e.g., art work) for promotional, commercial, informational, and educational purposes in any and all media (including the Internet) now existing or hereafter devised, for any purpose consistent with the Program’s mission. I understand that I will not have an opportunity to review or approve uses of the Recordings or Works.
I recognize that the Program, through the Board of Trustees of Western Michigan University (“University”), holds the copyright in all Recordings. I understand that neither my child nor I will receive payment or any other compensation for the taking or use of any Recordings or Works created as a result of my child’s participation in the Program.
I release, indemnify and hold harmless the University from and against all liability, actions, debts, claims and demands of every kind whatsoever to the taking or use of the Recordings or Works of my child.