Student Release Form

All UNL students participating in music or dance ensembles or performances must complete and submit this electronic form

This form must be submitted to the Glenn Korff School of Music by the end of the second week of classes to be considered performance eligible. Absolutely no exceptions will be allowed.

Enter the information completely. Questions? Contact Music 2

Emergency Contact Information - Required for Off-Campus Travel
NOTE: must be someone with the authority to make medical decisions (parent, legal guardian, spouse...)

Please Read the Following Document Carefully

I irrevocably grant to the BOARD OF REGENTS of the University of Nebraska a public body corporate and an agency of the State of Nebraska and the University of Nebraska-Lincoln and its assignees, licensees and successors the right to record and use my performances as a student in the Glenn Korff School of Music during the 2014-15 academic year, including but not limited to, live performances; audio and video recording; radio, television and web broadcast; promotional material and presentations. I waive the right to inspect or approve versions of said recordings and/or performances and any share of profits derived from sale of said recordings and/or broadcasts.

I also irrevocably grant to the BOARD OF REGENTS of the University of Nebraska, a public body corporate and an agency of the State of Nebraska and the University of Nebraska-Lincoln and its assignees, licensees and successors the right to record and use my image and name in all forms and media including composite or modified representation for all purposes, including advertising, trade or any commercial purpose throughout the world. I waive the right to inspect or approve versions of my image used for publication or the written copy that may be used in connection with the images.

I release the BOARD OF REGENTS of the University of Nebraska a public body corporate and an agency of the State of Nebraska and the University of Nebraska-Lincoln and its assignees, licensees and successors from any claims that may arise regarding the use of my performances and image including any claims of defamation, invasion of privacy, or infringement of moral rights, rights of publicity or copyright. The University of Nebraska-Lincoln is permitted, although not obligated, to include my name as a credit in connection with my performance and image.

The BOARD OF REGENTS of the University of Nebraska, a public body corporate and an agency of the State of Nebraska and the University of Nebraska-Lincoln is not obligated to utilize any of the rights granted in the Agreement.

I have read and understand this agreement and I am 18 years of age or older.

This Agreement expresses the complete understanding of the parties. By clicking Submit, I verify that I am 18 years or older as of August 15, 2014.

If you are NOT 18 or older as of August 15, 2014, click the following link:

Download Minor Consent Form

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Make sure that you CLICK the SUBMIT BUTTON before exiting.
If you are under 18, be sure you submit both this form and the minor consent form.