Media Release Form


I, the undersigned, do hereby consent and agree that Fairfax University of America (FXUA) and its employees have the absolute right and permission to take photographs, video recordings, or other digital recordings of myself and my comments for use in any promotional materials and publicity efforts. I understand that my comments, photographs, and other recordings may be used in a publication (e.g., books, magazines, brochures), promotional materials, ads, electronic media (e.g., TV programming, web, social media), or other forms of promotion. I further consent that my name and identity may be revealed therein or by descriptive text or commentary.

I acknowledge that FXUA will assume ownership of all photographs, video and other media materials in which I appear and that FXUA has the right to crop or treat said media in its discretion. I also acknowledge that FXUA may choose not to use media in which I appear at this time, but may do so at its own discretion at a later date.

I waive any right to compensation arising from or related to the use of photographs, video recordings, or other media materials in which I appear. I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback.

I certify that the information I have given is factual and portray current conditions; it does not contain any representations that would be deceptive or could not be substantiated by FXUA.

I certify that I am at least 18 years of age. By signing this form, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational or marketing purposes.

Please fill out this release form for video recording and photos.

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