Simmons College

I understand that Simmons College is undertaking initiatives to promote the College, its schools and programs. I give Simmons College permission:

• To use, re-use, publish and re-publish, in whole or in part, the photographs or video of me or in which I am included, in any medium, without restrictions as to changes or alterations, in conjunction with the representation of Simmons College;
• To use my name in connection therewith if Simmons College so chooses.
• I understand and agree that photos of me may be taken by members of the media and published in media outlets.

I hereby warrant that I am of full age and am competent to grant permission in my own name in the above regard. I state further that I have read the above authorization, prior to its execution, and that I am fully familiar with its contents.

By typing my name in the boxes below, I understand that I am electronically signing this application:
(Parent or guardian may sign if subject is under the age of 18.)

Full name *

Date *

I prefer to decline photo consent at this time