Fillable PHOTOGRAPHIC CONSENT AND RELEASE FORM (a) Record my (Broward College)

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PHOTOGRAPHIC CONSENT AND RELEASE FORM (a) Record my (Broward College)

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Page 1 of 1 Photographic Consent and Release Form SBL 06/19/2012
PHOTOGRAPHIC CONSENT AND RELEASE FORM
I hereby authorize BROWARD COLLEGE (“BC”) and those acting pursuant to its authority to:
(a) Record my likeness and voice on a video, audio, photographic, digital, electronic or any
other device or medium;
(b) Use my name in connection with these recordings; and
(c) Use, reproduce, exhibit or distribute in any medium (including but not limited to, print
publications, video tapes, CD-ROM, Internet, social media, or any other medium) these
recordings for any purpose that BC, and those acting pursuant to its authority, deem
appropriate, including promotional or advertising efforts.
I release BC and those acting pursuant to its authority from liability for any violation of any
personal or proprietary right I may have in connection with such use. I understand that all such
recordings, in whatever medium, shall remain the property of BC, and that I will not receive any
compensation for the use of such recordings. I have read and fully understand the terms of this
release.
Name:
Address:
City:
State:
Zip:
Phone:
Signature:
Date:
Parent/Guardian Signature (if under 18):
Date:
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PHOTOGRAPHIC CONSENT AND RELEASE FORM (a) Record my (Broward College)

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Completed 18 August 2020

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