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UMR RELEASE FOR USE OF VISUAL IMAGES AND STUDENT QUOTES
I authorize the University of Minnesota Rochester to allow my image, likeness and attributed quotes to be used by University officials in news stories and reports, social media, external and internal websites, video and for general publicity purposes, including printed pieces, and without any compensation or additional consideration to me. I represent that I am of full legal age and competent to make this agreement.

I understand that if I do not want my image to be used in this manner, it is my responsibility to remove myself from any area where photography or videography is underway.
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Full Student Name *
Electronic Signature (By typing your name you are providing your signature) *
University Email Address
Anticipated UMR Graduation Year
Date *
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