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School of Education

Monmouth University Consent and Release Form

Please review this information and then complete and submit the associated form below.

By entering my name below, I hereby give Monmouth University the right to record and use in perpetuity my name, likeness, voice and statements/quotations in connection with my participation in activities and classes related to the School of Education at Monmouth University. I also give Monmouth University the right to use such recordings as a resource for University and archival purposes. I understand and agree that the University shall be entitled to use my picture, statements, or quotations as stated above subsequent to my participation in these activities and that my picture, statements or quotations may be used in print, electronic and/or digital form in a published book or otherwise.

I understand and agree that this release includes, without limitation, the right to use, reproduce, exhibit, distribute, publish and broadcast worldwide, in full or in edited version, such images and information in Monmouth University’s newsletters, on the Monmouth University website, on internet sites and in social media, including, but not limited to YouTube, Apple iTunes U, and in public relations/promotional materials such as marketing and admissions publications, advertisements, fundraising materials and any other Monmouth University-related publications for any purpose that Monmouth University and those acting pursuant to its authority deem appropriate. Such images and information may appear in any of the wide variety of formats and media now available and that may be available in the future, including but not limited to all mediums, including without limitation the following: electronic/online media (for example, websites and electronic mailings); radio; television (local, public, cable, satellite, and/or digital TV); video (DVD); print media (lyrics); and successor technologies (any other media, method, system, form or manner now or hereafter known invented or used). I understand and agree that all such recordings, in whatever medium, shall remain the property of Monmouth University. I understand and agree that I shall not be entitled to any compensation of any nature, monetary or otherwise, from Monmouth University in return for allowing this use.

I release Monmouth University and those acting pursuant to their authority from liability for any violation of any personal or proprietary right I may have in connection with such use. I certify that I have carefully read and fully understand this Consent and Release form before signing it, and I represent that I am voluntarily signing this Form.

By signing my name and inserting the date, I acknowledge and agree that I am submitting an electronic signature indicating that I have read and agree to accept all of the terms and conditions set forth in this Consent and Release Form. I further acknowledge and agree that a facsimile copy, PDF or photocopy of my signature hereto shall be valid and shall have the full force and effect as an original. I understand and agree that it is recommended that I print a copy of this Consent and Release Form for my file. If I do not wish to submit an electronic signature, I may request that a paper copy be provided to me for my signature.