HTML Preview Adult Photo Release Form page number 1.
Photo Release Form — Adult
I grant permission to use my photograph in print or online materials designed for news,
informational or educational purposes related to the University of Wisconsin-Madison.
Print Name
_________________________________________________________________________________________________________________________________________________________
Address
________________________________________________________________________________________________________________________________________________________________
Phone
_________________________________________________________________________________________________________________________________________________________________
Signature
_____________________________________________________________________________________________________
Date
_________________________________________
Photo Release Form — Minor
I grant permission to use photographs of my minor child in print or online materials
designed for news, informational or educational purposes related to the University
of Wisconsin-Madison.
Child’s name
______________________________________________________________________________________________________________________________________________________
Print parent or guardian name
___________________________________________________________________________________________________________________
Address
________________________________________________________________________________________________________________________________________________________________
Phone
_________________________________________________________________________________________________________________________________________________________________
Signature
_____________________________________________________________________________________________________
Date
_________________________________________
University Communications
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University of Wisconsin-Madison
500 Lincoln Drive
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19 Bascom Hall
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Madison, WI 53706
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608/262-3571
711 State Street
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Suite 200
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Madison, WI 53703
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608/262-0948