I, the undersigned, do hereby consent and agree that , its employees, or agents have the right to take photographs, videotape,
or digital recordings of me beginning on and ending on and to use these in any and all media, now or hereafter known, and
exclusively for the purpose of . I further consent that my name and identity may be revealed therein or by descriptive text or
commentary. I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent
transmission or playback.
Name:                                                                                 Date:_______________________

Address:_________________________________________________________________

Phone:                                                                                                                                     

Signature:______________________________________________________________________

If you are under eighteen (18) years of age, your parent or guardian must sign below:
I represent that I am a parent/guardian of the minor who has signed the above release and that in that capacity
Lincoln University has my consent and authorization to use the name, voice and/or likeness as described above.

Signature:__________________________________________Date:__________________

Print Name:___________________________________________________________________