Consent, License and Release Agreement

You have been asked to complete this form because a representative from the College of Health and Human Development has photographed, filmed, or recorded you as part of a mulitmedia or news related story. In order to use the media that we captured, we need your consent.

Contact Information

Please enter your phone number as ###-###-####.

Since the subject is under the age of 18, a parent or legal guardian must provide their consent as well. 

Download the Consent Form, sign it, and upload it below. After you upload the form below, please click on "submit" at the bottom of this page to complete the process.