Standard Release Form - San Diego Community College District
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1Standard Release Form
I hereby authorize the San Diego Community College District and any news-gathering organization to publish my
photograph, video and audio tape of me, with or without using my name, for use in news programming or electronic or
print publication of college or continuing education information material, multimedia presentations, World Wide
Web/Internet, television public service announcements, or for use in any lawful manner deemed appropriate for public
information by the San Diego Community College District and/or news organizations.
Name: ____________________________________________________________
Email Address (please print clearly): ____________________________________
Address: __________________________________________________________
City/State/Zip: ____________________________________________________
Contact #: ________________________________________________________
K I represent that I am 18 years of age, and have the right to enter this agreement.
Signature: ______________________________________ Date: ____________
K I am under 18 years of age.
Signature of parent or guardian: ______________________ Date: ____________
Standard Release Form
I hereby authorize the San Diego Community College District and any news-gathering organization to publish my
photograph, video and audio tape of me, with or without using my name, for use in news programming or electronic or
print publication of college or continuing education information material, multimedia presentations, World Wide
Web/Internet, television public service announcements, or for use in any lawful manner deemed appropriate for public
information by the San Diego Community College District and/or news organizations.
Name: ____________________________________________________________
Email Address (please print clearly): ____________________________________
Address: __________________________________________________________
City/State/Zip ______________________________________________________
Contact #: ________________________________________________________
K I represent that I am 18 years of age, and have the right to enter this agreement.
Signature: ______________________________________ Date: ____________
K I am under 18 years of age.
Signature of parent or guardian: ______________________ Date: ____________
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