Geisel Media Consent Form

    Overview
    I hereby consent to the collection and use of my personal images by photography or video recording.

    I acknowledge these may be used on the Geisel website and the dartmouth.edu family of websites; Geisel and Dartmouth social media; as well as in Geisel, and Dartmouth newsletters and publications.

    I further acknowledge that my image and recordings may be used by the Geisel School of Medicine at Dartmouth and media to promote the school and its work in the future. This includes the unrestricted right to use, reproduce, and publish photographic, video, and audio recordings for editorial, promotional, advertising, or any other purpose and in any medium that promotes the Geisel programs at Dartmouth.

    I agree that I may be identified by name in photo captions where relevant.

    No implicit editorial or financial rights are assumed or relinquished with my consent.

    I also understand that my consent can be withdrawn at any time in writing to the Office of Communications at 74 College Street, Vail 7, Hanover, NH 03755.
    Consent Acknowledgement
    I consent to the use of photographs or video footage for use on the dartmouth.edu family of websites Geisel and Dartmouth social media, as well as in Geisel and Dartmouth newsletters and publications.

    I consent to the use of photographs or video footage to promote the school and its work in the future.

    I further understand that this consent may be withdrawn by me at any time, upon written notice.

    I give this consent voluntarily.