Virginia Model Release Form 1
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Model Release Form
Individuals have a legal right to their image. This means that if an individual is displeased
with the placement of his/her photo for any reason then he/she is able to pursue legal recourse.
One of the exemptions is if the photograph or image is used by the news media. In College
publications, SwVCC’s use of an individual’s photograph(s) falls under promotion and
advertising. To protect the College and to ensure that the individual has given permission for
SwVCC to use a photo of him/her, have the individual(s) fill out a model release form.

APPENDIX B
Model Release Form
Subject ________________________________________________
Date

_____________________________________________________

I give my permission for Southwest Virginia Community College to use my likeness in this
photograph/video for use in any publications or publicity to promote the college or any of its
programs and services.
Name _____________________________________________________
Name ______________