Computer Science Photo/Video/Quote Release

I hereby give permission to the Computer Science Department of Western Washington University to use quotes, photographic images, audio, and/or video footage of or by me in its public informational activities and marketing without compensation to me. This could include use in Western publications, advertising, web pages, social media, video and television. At the discretion of the Computer Science Department and University Communications and University Marketing, use could also include making this information or my image available to non-university organizations that publish news about the university, such as newspapers, magazines, news broadcasters and other news organizations. This permission is granted for an indefinite time period.

Required fields are marked with an asterisk (*).

Type your full name

This acts as your signature and indicates that you agree to the terms listed above. If this is for a minor(s), it must be signed by a parent or guardian.

Today's date

Preferred pronouns

Minor(s) in photo?

Yes

Name of minor(s)

Separate multiple names with a comma

Relationship to minor(s)

Phone Number

Western email (@wwu.edu) preferred if applicable

What is your affiliation with Western?

Name of photographer/videographer

Event/photo description

Emailing photo/video/quote?

Leave blank if this photo/video/quote was taken in person

Email you are sending the photo/video/quote from