Release Form For Images/Videos Submitted By a Student

By completing this form:

I grant Rutgers University all rights to use the images and/or videos that I submitted in any medium for educational, promotional, advertising, or other purposes that support the mission of the university.
I verify that I am the owner of the images/videos that I submitted.
I verify I am the only person identifiable in the images/videos.

If there are any other adults depicted, I will have them fill out a Rutgers Model Release form. (See below.)
If there are any minors (persons under age 18) depicted, I verify that I am their parent or legal guardian and I grant Rutgers permission to use the image(s) in which they are identifiable.

*Only the fields marked with an asterisk below are required.

Type Your Full Name to Sign

Phone Number

Company (put N/A if not currently employed)

Job Title / Job Role

Country

Street Address

City

State

Provinces

State/Province

Zip/Postal Code

Are there people other than you that are identifiable in the images/videos you provided?

YesNo

In the textbox below, please provide the full names and a brief description of each person.

NOTE: You will need to secure permission from each individual depicted before we can use the files you provided. Please send our Model Release Form link to each person:
https://www.tfaforms.com/5046579