College Board Model Release Form

Page 1

Authorization and Release Form By my signature below, I do hereby understand, agree and give my full and complete permission to the College Board to photograph me and make audio (sound) and video (picture) recordings of me. For the purposes of this release, these photographs and recordings are referred to as “Images”. I grant the College Board and its designees, affiliates and licensees (collectively the “College Board”) the right to use, edit, reproduce, broadcast, publish, exhibit, publicize, and otherwise exploit and distribute, without compensation to me, any Images, along with my name (“Identity”) and any statements and/or comments that I make, on the College Board website, in videos, print materials, and in other formats and mediums now known or hereafter developed. The rights granted to the College Board are perpetual and worldwide. I acknowledge that the College Board will rely on this permission and that the College Board, in its sole discretion, may decide whether or not to use the Images and Identity. I will not assert a claim that such use of the Image and my Identity, as stated above, is a violation of my rights. I further understand and agree that I am hereby waiving all rights and claims to ownership of the College Board materials in which my Image and/or my Identity may appear. I expressly release and indemnify the College Board and its officers, employees, agents and designees from any and all claims, known or unknown, arising out of or connected with the above granted uses and permission. This agreement is the full and complete understanding between the College Board and me and I have had adequate time to read this document carefully and to ask any questions that I may have. Please Print:

Name

(if under 18yrs old, Parent/Guardian signature required below)

Signature

Street Address, City, State

Email address

Date

Parent/Guardian Name

Signature

College Board Release Form 01/10


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