Media Consent Form & Release for Minor Student/Children

I am the parent/guardian of (print full name of Student/Child) (“my Student/Child”). I hereby grant Oakland Community College (“OCC”), and their agents the absolute right and permission to use photographic portraits, pictures, digital images or videotapes of my Student/Child, or in which my Student/Child may be included in whole or part, or reproductions thereof in color or otherwise for any lawful purpose whatsoever, including but not limited to use in any OCC publication or on the OCC websites, without payment or any other consideration.

I hereby waive any right that I may have to inspect and/or approve the finished product or the copy that may be used in connection therewith, wherein my Student/Child’s likeness appears, or the use to which it may be applied.

I hereby release, discharge, and agree to indemnify and hold harmless OCC, its Board of Trustees, employees and agents from all claims, demands, and causes of action that I or my Student/Child have or may have by reason of this authorization or use of my Student/Child’s photographic portraits, pictures, digital images or videotapes, including any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said images or videotapes, or in processing tending towards the completion of the finished product, including publication on the internet, in brochures, or any other advertisements or promotional materials, including claims of invasion of privacy or libel.

I represent that I am at least eighteen (18) years of age and am fully competent to sign this Release.

Please don't fill out this input box.

Date of photo*

Location of Photo Shoot*

Auburn Hills

Highland Lakes

Orchard Ridge

Royal Oak

Southfield

Other location

Please check one of the boxes below

CONSENT: I hereby certify that I am the parent or guardian of the above named Student/Child and do hereby give my consent without reservation to the foregoing on behalf of my Student/Child.

NON-CONSENT: I hereby certify that I am the parent or guardian of the above named Student/Child and do not hereby give my consent without reservation to the foregoing on behalf of my Student/Child.

Name of Minor Student/Child

Parent/Guardian's Name*

Email Address

Primary Phone Number