Release to use photograph or video footage

Complete and submit online. You can also print this page, complete the form, and either email or mail the form to:; Mail: Jessica Lee, 5031 LIB, Main Library, University of Iowa, 125 West Washington Street, Iowa City, IA 52242
  • MM slash DD slash YYYY
    The date the picture was taken
  • I give permission to use photos and or video footage of me taken on the date listed above, by the photographer/videographer listed above, at The University of Iowa Libraries. I am releasing these photographs and or video footage to be published by the photographer/videographer in print, web, and social media.