Photo Release - Form

I hereby grant JCC permission to use my name, likeness, and/or biographical information in any and all media, now known or hereafter developed, in connection with publications, news releases, advertising and other materials generated by JCC to support, promote, and encourage awareness of the college. I understand that I will not receive any compensation as a result of the use of my name, likeness, and biographical information as described in this release. I waive any rights of privacy and/or approval of the materials in which my name, likeness, and biographical information are used. No use of my name, likeness, and/or biographical information shall be the basis of any future claims of any kind against JCC, nor shall this release be made the basis of any such claim.

*Required - Student Name (signature)

Provide your full name. This will represent your signature.

*Required - Student ID number

Please provide your JCC Student ID number

*Required - Address

Please provide your current address

*Required - Phone Number

Please provide a phone number where you can be reached including the area code xxx-xxx-xxxx