I hereby consent and authorize Grossmont-Cuyamaca Community College District to use and
reproduce my photograph, name and/or biographical information in all forms of media, including
publications and advertising materials. I will make no claim of any kind. I understand I will not
receive any compensation as a result of the use of my photograph and corresponding
I hereby warrant that I am of legal age and have the right to contract in my own name.
This consent and release may be revoked only in writing delivered to the Advancement and
Communications Office of the Grossmont-Cuyamaca Community College District. Any such
revocation will apply only to materials to be distributed in the future and not to any materials
already printed or otherwise created at the time of revocation.
PHOTO INFORMATION: (instructor and course, or general description of photo)