Photo/Video Opt-Out

Complete and submit this form for the Marketing & Communications division ONLY if you do NOT give permission for your photo, audio, or video to appear in university publications and/or publicity, including the campus website and social media. This opt out request is effective for one year (September 1 - August 31). It must be accompanied by a current photo of the student and must be renewed each year in order to be valid. Please be advised that images and videos taken in public spaces and/or public events do not require authorization for publication. 

I do not authorize Pacific Lutheran University, or its officers, employees or agents, to record my photographs or other images or likenesses in the form of audio, video, or any other medium, or to use, reproduce, modify, distribute, or publicly exhibit such recordings, in whole or in part, for any purpose. Further, I do not consent to the use of my name, voice, or biographical material in connection with any such recording. 

If you are under 18, a parent or legal guardian of the student must sign and submit this form.

Student Information

Student Name*
Picture of the Student
No File Chosen
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I hereby confirm that I am of legal age (18) and have every right to contract in my own name as stated above.*
I hereby confirm that I am the parent or guardian of the student named below.*
I further affirm that I have read the above "Photo Opt Out Release" and am familiar with its contents.*

Contact Information