Media School Model Release

Looking for a printable copy? Download a PDF of this form.

  • I, a student of the Indiana University Media School (“Media Student”) authorize The Trustees of Indiana University (“IU”), acting through its agents, employees or representatives, to take photographs, video recordings, and/or audio recordings of me at any and all IU Media School events and external excursions, including my name, my image, my likeness, my performance, and/or my voice (“Recordings”). I also grant IU an unlimited right to reproduce, use, exhibit, display, perform, broadcast, create derivative works from, and distribute the Recordings in any manner or media now existing or hereafter developed, in perpetuity, throughout the world. I agree that the Recordings may be used by IU, including its assigns and transferees, for any purpose, including but not limited to, marketing, advertising, publicity, or other promotional purposes. I agree that IU will have final editorial authority over the use of the Recordings, and I waive any right to inspect or approve of any future use of the Recordings. I acknowledge that I am not expecting to receive compensation for participating in the Recordings or for any future use of the Recordings. I release and fully discharge IU, and its employees, agents, and representatives, from any claim, damages, or liability arising from or related to my participation in the Recordings or IU’s future use of the Recordings.

  • By signing the electronic signature below, I acknowledge that I have read this entire Consent and Release Form, I fully understand it, and I agree to be bound by it. I represent and certify that my true age is at least 18 years old, or, if I am under 18 years old on this date, my parent or legal guardian must indicate consent by providing their electronic signature or submitting a hard-copy signature.

  • Are you under 18?

    If the participant is under 18 years of age, please provide your parent or legal guardian’s email address in order for IU to obtain an electronic signature. If email communication is unavailable, please submit a hard-copy parent or legal guardian signature of this form and submit to Audrie Osterman, IU Media School, Franklin Hall 320B, Bloomington, IN 47405 or, 812-855-1725. Download the hard copy.

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