Media Release – Active Consent

Albion College Active Consent Form

Parent/Guardian Active Consent to Use a Minor’s Image, Voice, and Work in Marketing Materials.

Program: Boundary Crossings / Maemester
School District: Marshall Public Schools (MPS)
College: Albion College

Biographical Information

Student (Minor) Name:(Required)

First Last

Date of Birth(Required)

Student (Minor) School / Grade:(Required)

Parent/Guardian Name:(Required)

First Last

Parent/Guardian Email:(Required)

Note: We will only contact parents or guardians if requested.

Parent/Guardian Phone:(Required)

Note: We will only contact parents or guardians if requested.

About the Program

The Boundary Crossings / Maemester partnership between Albion College and Marshall Public Schools connects college students and local classrooms in meaningful ways—helping future educators learn through experience while inspiring younger students to explore, create, and grow. To celebrate the 20th year of this long-standing collaboration and share its impact, Albion College and MPS periodically feature photos, videos, and stories from the program in communications that highlight the value of this community-based educational partnership.

1) What you’re consenting to

By checking “I CONSENT” and signing below, I am the parent or legal guardian of the minor named above and I give permission to Albion College and Marshall Public Schools, and their employees, agents, and partners, to record, photograph, and/or collect the minor’s image, voice, name, quotations, and student-created work (collectively, “Materials”) in connection with Boundary Crossings / Maemester activities.

2) How the Materials may be used

I authorize use of the Materials only to promote the Albion College Education Department and the Albion College–Marshall Public Schools Boundary Crossings / Maemester program. This includes, but is not limited to, use on Albion College or Marshall Public Schools websites, social media, email updates, printed materials, presentations, and internal or external publications—in any media now known or later developed, worldwide.

3) Duration and revocation

This consent is ongoing but may be revoked at any time for future uses by emailing [email protected] and [NAME]@marshallpublicschools.org. Revocation does not require removal of prior uses already produced, published, or in distribution.

4) Safety and contact

If I have questions or wish to limit specific uses, I can contact: Albion College Office of Marketing & Communications: [email protected]. Marshall Public Schools: [NAME]@marshallpublicschools.org.

Consent (Choose One Option)

Digital Signature:(Required)

Typing your name shall serve as your signature, verifying your responses above.

Relationship to Minor:(Required)

i.e. mother, father, guardian

Today's Date:(Required)