PROMOTIONAL RELEASE
for minors
name of minor ____________________________________
primary phone number _____________________________
secondary phone number ___________________________
city where you live _________________________________
program of study (if applicable) __________________________
campus where you will attend classes (if applicable) _____________
parental or guardian release:
I hereby release Roane State Community College from any claim relative to the publishing of any photograph and/or promotional or news copy in which I am a participant.
This applies to commercial advertising, news coverage, promotions or public service
on TV radio, video, Web site or in newspapers, magazines or other such recruiting and
promotional print pieces.
I have read and understand the release stated above and allow the above minor to
participate in Roane State Community College promotional activities.
_______________________________________________________ Date _________
Signature