Mines Photo/Multimedia Model Release Form

All photographers and videographers taking photographs, videos or audio recordings on university property or at university events in their capacity as Mines’ employees must obtain a signed release from any student, faculty member, staff member, or community member who is visibly recognizable in the photograph or recording prior to making any commercial use of such photograph (including use in all public relations materials and marketing materials used to promote or market Mines’ or its departments such as websites, newsletters, brochures, magazines, signage or other similar materials). Crowd scenes where no single person is the dominant feature are exempt as are photographs taken of news events. However, photographs taken for news purposes require a release prior to reuse in public relations or marketing materials.

* denotes a required field

First Name*

Last Name*

Email Address*

Date of Birth*

What department do you work in?*

Major*

Mines Graduation Year (example: 2019)*

I hereby grant Colorado School of Mines permission to use my likeness in photograph(s)/video or audio recordings in perpetuity, in any and all of its publications and media (including the internet), now or in the future, controlled by Colorado School of Mines.

I waive any right to inspect or approve the finished product, and I waive any right to compensation. I release, indemnify and hold harmless the Colorado School of Mines and its Board of Trustees, officers, directors, employees, agents and representatives from any claims, damages, or liability arising from or related to the use of the photograph(s)/video or audio recordings.

I agree with the statement above.*

Yes

E-Signature*

Parent/Guardian Signature (if student is under 18 years of age)

Please Note
This Photo/Multimedia Release will remain in place unless and until you take affirmative action to revoke your consent.

For Internal Purposes

Submitter requested a change to their statement decision.

Guardian Signature (if student is under 18 years of age)