FERPA Agreement

STUDENT PRESENTATION PERMISSION AND FERPA RELEASE

 

I hereby grant to The Regents of the University of California, on behalf of the Merced campus, permission to record by means of audio-visual analog and/or digital medium the presentation, lecture(s), interviews, and related materials I will prepare and present as part of Innovate to Grow (“Presentation”) and to reproduce the Presentation, including any written materials or visual aid utilized during the Presentation, my name, likeness, identity, voice, photographic image, videographic image and oral or recorded statements (hereafter “Related Appearance”) for research or educational use subject to the following restrictions:

 

1. The Presentation and Related Appearance will be utilized for the program listed above only. The material will be available online via a video stream which may be accessed by UC Merced staff, faculty, and the general public.

    

2. The Presentation and Related Appearance will be available online during May 13, 2022 and will be subsequently archived for reuse.

    

3. UC Merced will use the Presentation and Related Appearance for educational purposes only and not for any commercial/promotional purposes or activities.

 

By signing this form, I waive and release The Regents of the University of California and its officers, agents and employees, from any claim or liability relating to the use of the Presentation and Related Appearance in conformance with the restrictions stated above.

 

FERPA RELEASE: I understand that the media may be protected by the Federal Educational Rights and Privacy Act (“FERPA”) as educational records. I hereby consent to the disclosure of the presentation by the University to faculty, staff, students, and visitors of the University, which may include the general public. The purpose of this disclosure is to advance the educational mission of the University.

 

This Agreement shall be governed by and interpreted in accordance with the laws of the State of California. This Agreement expresses the complete understanding of the parties with respect to the subject matter and supersedes all prior representations and understandings.

 

I acknowledge that The Regents of the University of California will rely on this permission and release in producing and distributing the Presentation and the Related Appearance.

 

I am an adult, 18 years or older, and I have read and understand this agreement and I freely and knowingly give my consent to the The Regents of the University of California, on behalf of the Merced campus, as described herein.

 

 

Printed Name Email

 

 

 

Signature Date

 

If individual photographed/recorded is under eighteen (18) years old, the following section must be completed: I have read and I understand this document. I understand and agree that it is binding on me, my child (named above), our heirs, assigns and personal representatives. I acknowledge that I am eighteen (18) years old or more and that I am the parent or guardian of the child named above.

 

 

 

Printed Name Email

 

 

 

 

Signature Date