PHOTO AND VIDEO CONSENT AND RELEASE FORM
Participant Name: _________________________________________________________Date:________________
Address:___________________________________________________________Phone:____________________
E-mail:________________________________ MC Course/Event (if applicable): ___________________________
This Agreement is between Montgomery College and the Participant with respect to the reproduction of either a
performance or a photograph/video described below. The parties agree as follows:
I voluntarily grant to Montgomery College the absolute and irrevocable right and unrestricted permission to use
my name, likeness, image, voice and/or appearance in any photos, video recordings, audiotapes, digital images,
and the like, taken or made on behalf of the College or its partners.
I agree that Montgomery College has complete ownership of such material and can use said material for
any purpose consistent with the College’s mission. These uses include, but are not limited to photographs,
videos, publications, advertisements, news releases, websites, and any promotional or educational materials in
any medium.
I acknowledge that I will not receive any compensation for the use of such images, video, likeness, etc.
I release, waive, forever discharge, hold harmless and covenant not to sue Montgomery College, its trustees,
employees, students, contractors, agents or representatives from and against any and all liability for any harm,
injury, damage, claims, actions, causes of action, costs, demands, and expenses of any nature whatsoever relating
to the making, showing, distribution or use of my likeness in photos or videos made by Montgomery College.
Montgomery College and its successors and assigns shall have the full, exclusive and complete ownership of said
material produced pursuant to this release, which shall be deemed the sole property of Montgomery College, all of
which ownership and other rights I grant to Montgomery College for good and sufficient consideration.
This Agreement constitutes the entire agreement between the parties and is governed by Maryland laws.
Any modification of this Agreement must be in writing, signed by both parties.
I represent that I am over the age of eighteen (18) years and that I have read the foregoing and fully understand its
contents. This release shall be binding upon me, my heirs, legal representatives, and assigns.
AGREED AND ACCEPTED:
___________________________________ _____________________________________________
Participant Signature Montgomery College Representative Signature
___________________________________ _____________________________________________
Participant Printed Name Montgomery College Representative Printed Name
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
