Photo Consent Form

University of California, Natural Reserve System

From time to time, the University of California Natural Reserve System (NRS) makes videos,
photographs, or audio recordings of activities in or related to NRS reserves. These photographs, tapes, and videos are used solely in support of the NRS and its research, educational, and outreach missions. Their uses include, but are not limited to, NRS brochures, its website, books, and materials sent to media outlets that inform the public about various activities at NRS reserves. These products may be excerpted in newspapers and magazines, or republished in electronic media. We appreciate your cooperation in signing the following consent for the University to use all and any images or sounds of you appearing in these photographs, videos, or audio tape recordings. I understand the photograph(s) or video or audio recording(s) taken of me by agents, employees, or representatives of The Regents of the University of California (hereinafter called “the University”) shall be used in connection with the University’s dissemination of information by its public service and academic programs to the general public.

I hereby irrevocably authorize the University to copy, exhibit, publish, or distribute any and all
such images and audios of me or in which I appear, including composite or artistic forms and
media, for purposes of publicizing University programs or for any other lawful purpose. In
addition, I waive any right to inspect or approve the finished product, including written copy, in
which my likeness appears.

I hereby hold harmless and release and forever discharge the University from all claims,
demands, and causes of action which I, my heirs, representatives, executors, administrators, or
any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

Phone

This field is for validation purposes and should be left unchanged.

Participant’s Name(Required)

First Last

Please enter your first and last name from the RAMS application.

Date(Required)

MM slash DD slash YYYY

Parent/Guardian’s Signature)

Under Age

If the person signing is under age 18, there should be consent by a parent or guardian, as follows: I hereby certify that I am the parent or guardian of , the minor named below, and do hereby give my consent without reservations to the foregoing on behalf of this person.

Signature(Required)

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