Academic Work Product Agreement
EDU0048 – Revised 03/26/2015
*Please note: You need to download and save the document to your computer first. Then re-open the document to activate the digital
signature box so you can digitally sign and email the completed form. You must have Adobe Reader in order to digital sign the form.
Do not click the lock document after signing the form.
I, ____________________ give my full consent for Mohave Community College to display my student-created work (art,
photography, video recording, audio recording, written work, verbal statements, or web-based material) or student identifying content
(audio recordings, photographs, and video images that include a student’s voice or image) for Mohave Community College’s
instructional, informational, public relations, promotion, and/or publicity purposes. I understand and acknowledge that I will not be
compensated and that the contribution of my artwork is wholly voluntary. I further agree:
1) I individually, hereby release, acquit, and forever discharge Mohave Community College and its agents, officers, officials,
and employees from any and all responsibility for any and all damages or losses including destruction, loss, or theft of any
items that I may exhibit during the display period, transportation to/from the display site, or during installation or removal of
the Exhibit.
2) I acknowledge that Mohave Community College is not providing any form of insurance for my artwork displayed in the
exhibit and I will purchase insurance, at my own expense, to cover my artwork, if I so desire.
3) In signing this Release & Consent Agreement, I hereby acknowledge and represent that I have read this entire document, and
that I understand its terms and conditions.
I understand that this student-created work and/or student-identifying content could appear in Mohave Community College
publications, including, but not limited to social media, emails, Newsletters, news releases or publicity materials (print, audio, or
video), in public exhibitions of student work, or on the official Mohave Community College web-site, located at www.mohave.edu. I
further understand that my student-created work or student-identifying content may be used in subsequent years even if the student has
sold the work, at the discretion of Mohave Community College.
I acknowledge that my consent to the above conditions is fully voluntary, given without coercion or duress.
Student Signature:
Print Name: ___________________________________________________________________
Signature: _________________________________ Date: ______________________
Email: ____________________________________ Phone Number: ______________
Parent/Guardian Signature (if the person named above is under 18):
Print Name: ___________________________________________________________________
Signature: _________________________________ Date: ______________________
Email: ____________________________________ Phone Number: ______________
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
