I, the undersigned, hereby grant the Board of Trustees of the University of Illinois for the University of Illinois Springfield (UIS) the absolute and irrevocable right and permission to use the picture, audio, or video taken of my child, as well as any audio or video, profile information or quotations provided, in (1) the video, photograph, audio recording, publications or other written materials, news stories, social media or websites for the university; and (2) any video, photograph, audio recording or written materials reproduced either in whole or in part from the video, photograph, audio recording, publications or other written materials, news stories or websites for the university regardless of whether these materials are used for fundraising, advertising, publicity, or any other purpose on behalf of either the University or the University of Illinois Foundation.

I warrant that I have the full right and authority to grant this consent. In addition, I waive all claims to compensation or damages based on the use of my child’s image, voice, or profile information/quotations, or all of the above, by either the University or the Foundation. I also waive any right to inspect or approve the finished product. I understand that this consent is perpetual, that I may not revoke it, and that it is binding on me, my heirs and assigns. 

I warrant that I am at least 18 years of age and that I am competent in my own name insofar as this consent is concerned. I further attest that I have read this consent form and fully understand its contents.