Photo and Video Release Form
I transfer to the Department of Pathology and Laboratory Medicine at Western University, all rights whatsoever which I have in any and all photos and videos taken of me at any point while I am enrolled as a student at, or as an alumnus/a of, Schulich Medicine & Dentistry.
I understand and agree that the photos and videos may be licensed for commercial gain by the photographer, videographer and his/her agents. I consent to the use of these photos and videos for all legal purposes (including, without limitation, advertising, display, editorial, packaging, promotion, television, etc.) for the Schulich School of Medicine & Dentistry and Western University.
The photographer or videographer may transfer his or her rights in these videos to others within Schulich School of Medicine & Dentistry at Western University and they may rely on this consent.
- PaLM Photo and Video Release Form (PDF, 122 KB)