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Media Release Waiver Forms

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  6. Media Release Waiver Forms

Florida State College at Jacksonville has three specific media release waiver forms to ensure proper permission and release is given to FSCJ by individuals who may be the subjects for photographs, videos, audio or other marketing/promotional or educational purposes. The three forms are listed below:

General Media Release Form

The General Media Release Form can be used at Collegewide and campus events, athletic games, fairs and other College promoted events. The second page of this form includes additional information on the general guidelines for the use of photos.

Multiple Entries Media Release Form (with FERPA language)

The Multiple Entries form is used for group settings where you may have multiple students or individuals participating in or at an event. This form includes specific language regarding FERPA rights for students.

FERPA Media Release Form

The FERPA Media Release Form includes specific language regarding FERPA rights for students. This form should be used for any photography, videography or audio recording that is taken inside the classroom on any of our campuses.

Media Release Waiver Instructions

WHO IS REQUIRED TO SIGN A MEDIA WAIVER FORM?

Students, faculty, employees and visitors who attend Florida State College at Jacksonville and participate in academic, athletic and/or other campus and non-campus activities. Individuals may be asked for their name, demographic information, and signature.

WHAT ACTIVITIES REQUIRE A SIGNED WAIVER?
Florida State College at Jacksonville academic, athletic and/or other campus and non-campus activities.

WHERE AND WHEN WILL PHOTOS, VIDEO AND STATEMENTS BE USED?
Images or statements may be used by FSCJ and others with regard to advertising, marketing, promotions, recruiting, and reporting the activity or event at the discretion of FSCJ.

WHAT INFORMATION NEEDS TO BE INCLUDED ON THE MEDIA WAIVER FORM?
College personnel should request that students provide their name and signature acknowledging that he/she will receive no compensation with regard to the use of their name, image/appearance, voice, comments, and demographic information. Individuals should print his/her name and then affix his/her signature.

If the individual is not eighteen (18) years of age, a parent or guardian should sign the Media Release Waiver Form.

DOES A COLLEGE REPRESENTATIVE NEED TO SIGN THE FORM?
The Media Release Waiver Form should be signed by the College employee. This signature can be provided by any employee representing the College activity or event and does not require a supervisor signature. Please ensure that all names are printed legibly.

If you have questions about this form, or need a different type of form, please contact the Office of General Counsel at (904) 632-3232.

Download the PDF forms here:

General Media Release Form

Multiple Entries Media Release Form

FERPA Media Release Form 

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Florida State College at Jacksonville is accredited by the Southern Association of Colleges and Schools Commission on Colleges (SACSCOC) to award associate and baccalaureate degrees. Florida State College at Jacksonville also may offer credentials such as certificates and diplomas at approved degree levels. Questions about the accreditation of Florida State College at Jacksonville may be directed in writing to the Southern Association of Colleges and Schools Commission on Colleges at 1866 Southern Lane, Decatur, GA 30033-4097, by calling (404) 679-4500, or by using information available on SACSCOC’s website (www.sacscoc.org). Florida State College at Jacksonville does not discriminate against any person on the basis of race, disability, color, ethnicity, national origin, religion, gender, age, sex, sexual orientation/expression, marital status, veteran status, pregnancy or genetic information in its programs, activities and employment. For more information, visit the Office of Civil Rights Compliance page.

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