Statement, Photo and Video Release Form

I do hereby give Thomas Edison State University, its officers, employees and agents the right to use my name and quotation or paraphrase of a statement I have made about the University, whether written or oral, in all forms and media, including University websites and publications, for advertising, promotional or educational purposes, trade or any other lawful purposes related to the University. I waive any right to inspect or approve the finished product, including written copy that may be created in connection therewith.

I also hereby give Thomas Edison State University, its officers, employees and agents, the right to use my name, along with any picture, image, photograph or video of me, in all forms and media, including University websites and publications, for advertising, promotional or educational purposes, trade or any other lawful purposes related to the University. I waive any right to inspect or approve the finished product that may be created in connection therewith.

I am of full age and have read this release and understand its contents.