The undersigned hereby irrevocably consents to the unrestricted use in perpetuity, for purposes including but not limited to display, advertising, and trade and including any alterations or modifications whatever of said visual image or images or testimony, by Delaware County Community College, its employees, faculty, agents, successors and assigns forever.

The undersigned waives any right which they may have otherwise to inspect or approve the visual images or edited text with regard to:

  1.  any alterations, edits or modifications
  2.  any material or commentary
  3.  any publication using the name of the undersigned, no name or a fictitious name
  4.  any use for the purposes of publicity, illustration, commercial art and
  5.  any advertising of products or services

Photo/Video/Testimony Release Form

Under 18 Years Old?(Required)
If under 18, parent or guardian must complete form
Electronic Signature(Required)
MM slash DD slash YYYY