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Consent *

I do hereby release and forever discharge Carleton University, its officers, Employees, representatives, and assigns from any and all demands, cause of action and/or judgments of whatsoever nature of character, past or future, known or unknown, whether in contract or in tort, whether for personal injuries, property damage, payments, fees, expenses, or damages of any kind or nature, and whether arising from common law or statute, arising out of, in any way, the use of my photograph or photographic image for official University business. This agreement does not include, or supersede other personal information agreements signed by me at Carleton University and concerning my personal information.

The personal information requested on this form is collected in accordance with Section 38(2) and 42(R.S.O.) 1990, c.F.31 of the Freedom of Information and Protection of Privacy Act (FIPPA). The information provided will not be used for any other purposes than those stated upon this form unless you direct otherwise. Direct any questions about the collection and use of this material to slals@carleton.ca. Carleton University is fully compliant with FIPPA and endeavours at all times to treat your personal information in accordance with this law.

This information will be retained and disposed in accordance with approved records retention and disposal schedules of the University.