Media/Photo Release Form

I, the undersigned, do hereby consent and agree that Wesleyan University Philippines
(hereafter known as WUP), its employees, or agents have the right to take my photographs,
videotape, audiotape or digital recordings for the purposes of the 70 Commencement
th

Exercises (Senior High School Program) on August 10, 2021. I hereby authorize WUP to edit,
alter, copy, exhibit, publish or distribute these photos, videos or audio recordings in any and
all media, now or hereafter, for any lawful purpose. I further consent that my name and
identity, such as but not limited to my residence address and academic degree completed,
may be revealed therein or by descriptive text or commentary.
I do hereby release to WUP, its employees and agents all rights to exhibit this work in print
and electronic form, including the Internet, publicly or privately. In addition, I waive the right to
inspect or approve the finished product, including written or electronic copy, wherein my
likeness appears.
I understand that there will be no financial or other remuneration for recording me, either for
initial or subsequent transmission or playback. I understand and agree that these materials
will become the property of WUP and that WUP is not responsible for any expense or liability
incurred as a result of my participation in this recording.
I have read this form, understood its contents and consent to the processing of my personal
data. I understand that my consent does not preclude the existence of other criteria for lawful
processing of personal data, and does not waive any of my rights under the Republic Act No.
10173 of the Philippines or the Data Privacy Act of 2012 and its corresponding Implementing
Rules and Regulations.
I represent that have read and understand the foregoing statement and am competent to
execute this agreement.