New Mexico State University

COOPERATIVE EXTENSION SERVICE

U.S. Department of Agriculture

Sandoval County Master Gardeners
Photo Release Form

Participants in NMSU, Cooperative Extension Service, Sandoval County Master Gardener events are
sometimes photographed and/or videotaped for use in promotional and educational materials. I
authorize New Mexico State University and the Sandoval County Master Gardeners to record and
photograph my image and/or voice for use by New Mexico State University, the Sandoval County Master
Gardeners or its assignees in research, educational and promotional programs. I understand and agree
that these audio, video, film, digital and/or print images may be edited, duplicated, distributed,
reproduced, broadcast, used in electronic and web media and/or reformatted in any form and manner
without payment of fees, in perpetuity.
I have read this release before signing below and I fully understand the contents, meaning and impact of
this release.
Signature _________________________________________________________________Date________
Printed Name _________________________________________________________________________

If the person signing is under age 18, there must be consent by a parent or guardian, as follows:
I hereby certify that I am the parent or guardian of _________________________________________,
named above and do hereby give my consent without reservation to the foregoing on behalf of this
person.
Signature of parent or guardian (of child under age 18) ___________________________Date________
Printed Name of parent or guardian _______________________________________________________