UCSC Photo/Video Release Form (group)

I give the University of California, Santa Cruz, the absolute right and permission to use a photograph(s) and/or video(s) of me in its promotional materials and publicity efforts. I understand that the photographs and/or videos may be used in a publication, print ad, direct-mail piece, electronic media (e.g., video, CD-ROM, Internet/WWW), or other form of promotion. I release the university,the photographer, their offices, employees, agents, and designees from liability for any violation of any personal or proprietary right I may have in connection with such use. I am 18 years of age or older.

Course Title & Number _______________________________________________________

Instructor's Name _________________________________________________________

Signature __________________________________

Students:

Print Name                     Signature                     Date

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Please return completed form(s) by campus mail to: Carolyn Lagattuta/University Relations.

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