Photography Release Form
Date:
Participant Name:
Project:
Location:
Photographer:
As per the information specified on this form:
I hereby consent to having my photograph taken by a representative of Durham Technical
Community College, and I understand that I have the right to revoke this authorization at any
time by submitting my request to revoke in writing.
Signature
I hereby consent that all photographs taken of me may be used by Durham Technical Com-
munity College for the purpose of illustration, advertising, college website information or
promotion, or publication/reproduction in any manner.
Signature
Participant Contact Information
Street
City State Zip
Phone Number
Email
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