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Strathmore Media Consent Form
Strathmore Media Consent Form
"
*
" indicates required fields
First Name
*
Middle Name
Last Name
*
Phone Number
*
Email Address
*
Category
*
Choose one
Guardian
Guest
International Faculty
Parent
Partner
Part-time Trainer
Strathmore Staff
Strathmore Student
Strathmore Alumni
Short Course participant
Name of Event / Purpose of Photo
*
Upload your Passport Photo
*
Accepted file types: jpg, png, pdf, Max. file size: 6 MB.
Age Group
*
Minor (below 18 years)
Adult (above 18 years)
Name of the Parent or Guardian
*
Parent/Guardian National ID Number
*
Passport Number / ID Number
*
Consent
*
I hereby give my consent to;
Strathmore University and its affiliates, agents and any individuals, entities or others acting under its authority or on its behalf (the ‘University’ ) to use my photograph, video, my quotes in an interview (or excerpts of quotes), film, tapes, my name, sound recording or my image and likeness in its publications, advertising or any other electronic or digital forms of media throughout the world.
I hereby assign to the University all rights, title and interests including copyright in and to any such photograph, video, quotes in interview (or excerpts of quotes), film, tapes, my name or sound recording in any digital format. I also agree that there will be no type of payment, royalty or fee in connection with the rights granted herein.
I hereby irrevocably authorize the University without limitation/restrictions in whole or in part and in any medium or content howsoever, including but not limited to, reproduce, exhibit, publish, distribute or disseminate any and all such photographs, videos or sound recordings in any digital format for purposes of promoting the University mission & vision, research, commercial, promotional or education purposes.
I release and discharge the University from all claims and demands arising out of or in connection to the use of any such photograph, video and sound recording, including but not limited to invasion of privacy, claims compensation and moral rights.
For a minor under 18 years of age
*
I agree to the privacy policy.
I am the parent or guardian of the above-named person, and I do hereby give my consent to Strathmore University and its affiliates on the terms of this media consent and release form on behalf of him or her.
The University is committed to processing your personal information in accordance with the University’s Data Protection Policy, Data Protection Act 2019 and its Regulations. The personal data collected as detailed will therefore be processed in line with the relevant Data Protection, Policies, Laws and Regulations in the way(s) and purpose(s) detailed in this Media Consent and Release Form.