Georgia Tech Student and Teacher Enhancement Partnership (STEP) Program Photographic Image Usage Purpose of the photos STEP staff members and graduate students will be taking pictures of the Georgia Tech graduate students, high school students, and teachers involved in the STEP program. These photographs, videotapes, motion pictures, or recordings (together referred to as “Images”) are strictly for the use of the STEP program in publicizing, reporting, and evaluating the program. They will not be used for any commercial purposes, and will not be used for publicity purposes by any organization or person not affiliated with the STEP program, Georgia Tech, participating school systems or the National Science Foundation. Images will be used in or on: Multimedia presentations about the STEP program. Brochures about the STEP program. Web pages related to the STEP program. Other publicity material or reports generated by Georgia Tech, participating school systems, the National Science Foundation, or other future financial sponsors. Images may be copyrighted by Georgia Tech and used in future publications from the institute, individually or in conjunction with other images. Foreseeable Risks or Discomforts Any photograph used by the STEP program for publicity will likely be viewed by many people unrelated to the participating groups. In addition, there is a risk that photos placed on web sites will be duplicated without permission from the site. Individual high school student identifiers will NOT be attached to the photographs, although school, STEP graduate student, and teacher names will be identifiable. Benefits STEP photographs will be used to benefit the program, school, school system, Georgia Tech, and the National Science Foundation by bringing positive attention to the program and to the participating individuals. Compensation No financial compensation will be provided to individuals whose images appear in STEP photographs. Confidentiality No high school students will be identified by name in any STEP photographs unless specific permission is given by the parents or guardians on a picture-by-picture basis. Approved as to Legal Form by Office of Legal Affairs 08/28/01 Financial Disclosure There will be no personal financial gain from these photographs by any of the STEP participants. Contact Person If you have questions, call or write: Dr. Donna C. Llewellyn Center for the Enhancement of Teaching and Learning Georgia Institute of Technology Atlanta, GA 30332-0383 (404- 894-2340, phone (404) 894-4475, fax E-mail: donna.llewellyn@oars.gatech.edu Please read and sign the attached release form and return to the participating teacher or school. Keep these cover sheets for your records. Approved as to Legal Form by Office of Legal Affairs 08/28/01 Georgia Tech Student and Teacher Enhancement Partnership (STEP) Program Photographic Image Release Form By signing below, you grant the Georgia Institute of Technology (GIT) and the Georgia Tech Research Corporation (GTRC) the right and permission to take photographs, videotapes, motion pictures, or recordings of you or your child in conjunction with the Student and Teacher Enhancement Partnership (STEP) Program, to copyright these images, and to reproduce these images for any legitimate purposes. You waive any right to inspect or approve the images before their use. By signing, you release GIT, GTRC, the Board of Regents of the University System of Georgia, and the participating STEP school systems from responsibility for damages of any kind arising from the use of the images, including claims for libel, invasion of privacy, or unauthorized misuse of the images. This authorization and release shall benefit the heirs, legal representatives, licensees, and other representatives assigned legal rights of GIT, GTRC, and the Board of Regents of the University System of Georgia. This release shall be binding upon me and my heirs, legal representatives, and any other person or representative to whom I assign my legal rights. _______________________________________ Student Name (Print & Signature) __________ Age ______________________ Date ____________________________________________________ Address ______________________ Phone Number ____________________________________________________ Parent or Guardian’s Name (Print & Signature) _______________________ Date ____________________________________________________ Address (if different from above) _______________________ Phone Number Approved as to Legal Form by Office of Legal Affairs 08/28/01