The release/use of certain, otherwise protected, information contained in the private records of student-athletes is often
necessary for the conduct of day-today business in pursuit of the mission and goals of the Lock Haven University
intercollegiate athletics program.
I, _________________________________________________, participating in ________have read and
(Print full name) (Sport/s)
agree to the provisions stated below as conditions for participating in intercollegiate athletics at Lock Haven University.
1. To allow designated members of the University faculty and/or staff to disclose and discuss medical and
academic/educational records with parent(s) or legal guardian(s).
2. To allow designated members of the University faculty and/or staff to disclose academic progress reports to coaches
,
athletics administrators, and the faculty athletics representative for the purpose of monitoring academic performance
and compliance with conference and NCAA regulations.
3. To allow designated members of the University faculty and /or staff to submit for publication my name, essential
educational records (including GPA), official photographs, and athletic accomplishments, for any awards, honors,
publications, etc.
4. To allow designated members of Athletics Communications and Marketing and/or athletics department staff to
release information to the media concerning participation status in areas including, but not limited to: medical,
eligibility, disciplinary (University or team rules) and/or personal.
In any and all circumstances, the privacy and dignity of the student-athlete is fundamental to the mission of both the
University and the athletics department, and will be protected.
Further, the student-athlete agrees to be accountable for all University, NCAA, Conference, and athletics department
policies as stated in the current Student and Student-Athlete Handbook as well as their respective conference on
Sportsmanship and Ethical Behavior.
_________________________________________ __________________
[Student-Athlete Signature] [Date]
______________________________________________________
[Parent/Guardian Signature (if student-athlete is under the age of 18)]
Release of Photo Consent 2020-21
The use of photos/images and artwork is often necessary to promote LHU Athletics on a day-to-day basis - including, but
not limited, to use on www.GoLHU.com - LHU’s official athletics website, game-day programs, releases, game recaps,
feature stories, schedule cards, posters, social media platforms, video/television production, admissions & alumni
material, fundraising & promotional content, among others.
I, the undersigned, allow members of the LHU University Relations and LHU Athletics Communication & Marketing
offices the use of my photo (head shot, action photos or staged marketing photos) for the use of communication and
marketing purposes - including, but not limited to, use on www.GoLHU.com - LHU’s official athletics website, game-day
programs, releases, game recaps, feature stories, schedule cards, posters, social media platforms, video/television
production, admissions & alumni material, fundraising & promotional content, among others.
____________________________________________ ___________________
[Student-Athlete Signature] [Date]
_______________________________________________________
[Parent/Guardian Signature (if student-athlete is under the age of 18)]
