Informed Consent for Multimedia Recording
I hereby authorize the Center for Students with Disabilities professional staff at The University of Connecticut (University), and those acting pursuant to its authority to:
(a) Record my likeness and voice on a video, audio, photographic, digital, electronic or any other medium.
(b) Use my name in connection with these recordings.
(c) Use, reproduce, exhibit or distribute in any medium whatsoever (including but not limited to print publications, video tapes, CD-ROM, Internet/WWW) these recordings for any purpose that the University, and those acting pursuant to its authority, deem appropriate for student service activities.
I release the University and those acting pursuant to its authority from liability for any violation of any personal or proprietary right I may have in connection with such use. I understand that all such recordings, in whatever medium, shall remain the property of the University.