O∆K Photo Release Form - Omicron Delta Kappa

Step 1 of 2

Name *

First

Last

Circle of Initiation *

Year of Initation *

YYYY

Email *

Mobile Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Description or List of photos provided *

File Upload

Click or drag files to this area to upload. You can upload up to 5 files.

Upload photos here. 5 files maximum in jpg or png format.

I agree to the following:

I authorize Omicron Delta Kappa, its assigns and transferees to use photographs or images provided by me in connection with the above-identified subject. I authorize Omicron Delta Kappa, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Omicron Delta Kappa may use such photographs provided by me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

Signature

I agree to the following:

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