SMI Photo/Video Opt Out Form
Photos and videos of campers are frequently taken by staff of the Summer Music Institute and other employees of Western Illinois University for use in programs, publications, web sites, social media and/or other marketing purposes. Parents (or students, ages 18 or older) must opt-out if they do not want their camper to be photographed for these purposes.
Email address *
I do not want my camper photographed/video taped or photographs/videos of published. *
Required
Camper Name *
Physical Description *
Parent/Guardian Name *
Date *
MM
/
DD
/
YYYY
Submit
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