QEP Video Contest
Consent & Release Form
I hereby authorize Brevard Community College to use photographs and/or videos of me and/or my
property for marketing and promotional purposes, including but not limited to, digital, print or
broadcast exhibit, publication, reproduction and advertising. I affirm that I or my legal guardian is of
legal age and have the right to agree with the terms of this release.
If older than 18:
Printed Name
Signature
Phone Number
B-Number
Date
If under 18:
Parent/Legal
Guardian Name
Relationship
Parent/Legal
Guardian Signature
Phone Number
Date