MU Major Update and Visual/Audio Image Release

Contact Information Update

This form is for department purposes only. If you have changes to your contact information, be sure to make updates for the university through the portal as well.

Your Contact Information
XXX-XXX-XXXX
month/date/year
Your Local Address Information
Your Permanent Address Information
Emergency Contacts
XXX-XXX-XXXX
XXX-XXX-XXXX

Visual/Audio Image Release

I grant permission to Cal Poly San Luis Obispo and its employees and agents to use my visual/audio content, which includes, but is not limited to, any type of recording, photographs, digital images, drawings, renderings, voices, sounds, video recordings, audio clips, concept ideas and any accompanying written descriptions. I represent that I took or otherwise created the visual/audio content and/or concept ideas and they are not an impermissible or otherwise unlawful copy, duplication or reproduction of another person’s work.

I agree that the visual/audio content may be used in any print, electronic or other media or format selected by Cal Poly at its sole discretion without notifying me. I further agree that the visual/audio content may be used by Cal Poly for any purpose, including but not limited to educational, marketing, public relations, websites, social media, publications, promotions, broadcasts, advertisements, and posters, as well as for non-university uses. I waive any right to inspect or approve the finished visual/audio content or any printed or electronic matter that may be used with them.

I further acknowledge that I have voluntarily agreed to take and/or provide the visual/audio content to Cal Poly without the promise of compensation or remuneration in any form whatsoever, and I waive any claim for compensation or remuneration of any kind for Cal Poly’s use or publication of the visual/audio content.

I release Cal Poly and any firm authorized to publish, broadcast and/or distribute a finished product containing the visual/audio content, from any claims, damages or liability, that I may ever have in connection with the taking or use of the visual/audio content or material used with the visual/audio content, including, but not limited to any and all claims for copyright infringement; invasion of privacy; defamation; false light or misappropriation of name, likeness or image.

I am at least 18 years of age and competent to sign this release*. I have read this release before signing, I understand the legal consequences of its contents, meaning and impact, and I freely accept the terms.

*If you are not 18, have a guardian complete the section below, "Visual/Audio Image Release (Under 18 Years of Age)"

By entering my name, I accept the terms of the above document

Visual/Audio Image Release (Under 18 Years of Age)

I am the parent or legal guardian of the minor Releasor. I have read this release before signing; I understand the legal consequences of its contents, meaning and impact; and I freely accept the terms on behalf of the minor Releasor and agree to be bound by the terms of this document. I have read this document, and I am signing it freely. No other representations concerning the legal effect of this document have been made to me.

By entering my name, I accept the terms of the above document
Relationship to Releasor
Parent/guardian phone number and/or email address

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