Participant Release Form

I, the undersigned, grant University of Wisconsin-Stout, and all agents and assigns acting on its behalf, the right to record photographic images, and/or video or audio of me, and to use, reproduce, modify, and distribute these recordings, and publicly exhibit such recordings, in whole or in part, in any medium, without restrictions or limitation, for any purpose the university deems appropriate. I further consent to the use of my name, voice and biographical material and comments in connection with such recordings.


I release the photographer and/or videographer and UW-Stout, its agents and assigns, from all claims and liability relating to the licenses I have granted in this release. I understand all pictures and recordings belong to the university and I waive all claims to compensation or damages based on the use of my image and/or voice or comments. Additionally, I waive any right to inspect or approve any such photographic and/or video images and comments, or completed products that incorporate all or part of any such photographic and/or video images and comments.


I certify that I am at least 18 years of age and have the right to grant the licenses contained in this release. I further attest that I have read this release form and fully understand its contents. By signing this document, you understand that your image and comments may be used on future marketing materials and/or media for advertising purposes that may include advertising, print materials, video, print ads and billboard.

Please use dashes between area code and phone number: 715-232-2284

By typing your full name in the box below, you are consenting to sign this form electronically. You have the right to complete a paper copy of this release by contacting stoutphotos@uwstout.edu By digitally signing this form, you are providing the release for this session only. If your contact information changes, you may contact stoutphotos@uwstout.edu to update your contact information.

Parent or Guardian Release

I certify that I am the parent and/or guardian of the person identified above, a person under the age of 18 years, and acknowledge the receipt of and consent to the terms of the release set forth at the top of this form. I certify that I am at least 18 years of age and have the right to grant the licenses contained in this release for the below mentioned person under the age of 18 years. I further attest that i have read this release form and fully understand its contents.

By typing your full name in the box below, you are consenting to sign this form electronically. You have the right to complete a paper copy of this release by contacting stoutphotos@uwstout.edu By digitally signing this form, you are providing the release for this session only. If your contact information changes, you may contact stoutphotos@uwstout.edu to update your contact information.