On Camera Release

In consideration of my engagement on camera, upon the terms hereafter stated, I hereby grant Adelphi University and/or its agents and their respective licensees, successors and assigns, the absolute right and permission to copyright and use, re-use and publish, and republish the still photography or all or any portion of the video footage of me or in which I may be included, in whole or in part, and/or any of my comments/conversations included as part of the video footage or any excerpts or reproductions thereof without restriction as to changes or alterations, from time to time, in conjunction with or without my own name,  likness and/or biographical data in written or electronic format and/or through any media now known or to be devised for documentary, promotional, artistic, marketing, trade or any purpose whatsoever.

I acknowledge that Adelphi University is obtaining this photography, video footage and interview for potential use for advertising and promotional purposes. As such, my photograph, video footage, interview, or portion of same, may included alone or with others, with or without my name, likeness and biographical information and may, at Adelphi University’s sole discretion, be disseminated and/or distributed across many mediums, including but limited to print, internet, social media, paid television, radio, etc.

I hereby, release, discharge and agree to save harmless, Adelphi University and/or its agents and their respective licensees, successors and assigns, and all persons acting under its permission or authority or those for whom Adelphi is acting, from any liability related to the taking of said still photography or video footage, any editing or alteration, or subsequent processing, intentional or otherwise, as well as any use, presentation, exhibition or streaming thereof. Nothing contained herein obligates you to exercise any of these rights, licenses or privileges granted to you by this release agreement.

Contact the Office of University Communications and Marketing in writing at UCOMM@adelphi.edu to discontinue usage of your image. Discontinuing use will not apply to any printed materials already in use.

I certify that the information given in this document is accurate. I hereby give permission to the Office of University Communications and Marketing to verify my academic and disciplinary records and I understand that this information will only be used in the selection process for individuals to be profiled in newsletters or otherwise featured in other publications and ads.

This release is governed by and will be construed in accordance with the laws of the State of New York.

I certify that I am over eighteen (18) years of age. If under 18 years old, a parent/guardian must sign.