Fillable Printable Visual/Audio Image Release Form - CSU

Visual/Audio Image Release Form - CSU

Communications

401 Golden Shore, 5th Floor, Long Beach, CA 90802-4210

562-951-4670 / Fax 562-951-4973

www.calstate.edu

Visual/Audio Image Release Form

I grant permission to California State University, its employees and agents, to take and use

visual/audio images of me. Visual/audio images are any type of recording, inc luding but not limited to

photographs, digital images, drawings, renderings, voices, sounds, video recordings, audio clips or

acc om pan ying written descriptions. CSU will not materially alter the original images. I agree that

CSU owns the images and all rights related to them. The images may be used in any m anner or media

without notifying me, such as university-sponsored websites, publications, promotions, br oadcasts,

advertisements, posters and theater slides, as well as for non-university uses. I waive any right to

inspect or approve the finished images or any printed or electronic matter that may be used with them,

or to be compensated for them.

I release CSU and its employees and agents, including any firm authorized to publish, broadcast and/or

distribute a finished product containing the images, from any claims, damages or liability which I may

ever ha ve in c onnection with the taking or use of the images or printed material used with the images.

I am at least 18 years of age and competent to sign this release. I have read this release before

signing, I understand its contents, meaning and impact, and I freely accept the terms.

Name (please print)

Date

Signature

Telephone or E-mail address

Signature of parent or guardian if under 18 years of age

Address (optional)

[ ] Employee Campus ID# [ ] Student Campus ID# [ ] Community Member

Office Use Only:

Project Name

(Photographer/Broadcast/Contact Information/Location/Notes/Photo Caption)