Homecoming 2025

Photo and Video Consent and Release Form
I, the undersigned, hereby give my consent to Howard University College of Dentistry and its designated partners to use photographs, video recordings, and other electronic media taken of me during the HomeComing and Open House. By signing this release, I acknowledge and agree to the following:

• Authorization for use
  • I grant permission for my image, likeness, and/or voice to be used in media created during the health fair, including but not limited to, photographs, video, and audio recordings.
  • I understand these materials may be used for promotional, educational, and informational purposes related to Howard University College of Dentistry and the health fair. This includes use in print, online (e.g. website, social media) and future promotional materials.
• No compensation
  • I understand that I will not receive any payment or royalties for the use of my image or likeness
  • I waive any right to inspect or approve the finish product or the copy that may be used in connection with my image.
• Health Information privacy
  • I understand that while my image may be used, it will not be associated with any specific medical screening results or personal health information shared at the health fair, unless I have provided separate, explicit consent for that purpose
  • I understand that no diagnosis, course of treatment, or other health conditions discussed at the fair will be disclosed in any of the media, not will it be used in a manner that compromises my privacy.
• Public environment
  • I understand that this is a public event and that my image may be captured in crowd shots or general event coverage where I am not the primary focus. My consent covers my inclusion in such media.
• Release of Liability
  • I release Howard University College of Dentistry, its organizers, volunteers, and partners from any claims, demans, or causes of action that I, my heirs, or any other persons acting on my behalf may have by reason of this authorization.
• Voluntary consent and revocation
  • I understand that this consent is voluntary and that I may revoke it at any time. Any revocation must be made in writing and submitted to Dr. Tanya Greenfield at Tanya.Greenfield@howard.edu
  • I understand that any use of my likeness in reliance on this consent before a revocation is received will be valid and binding.