Let us know you're coming :-) 

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* 1. First Name

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* 2. Last Name

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* 3. Best EMAIL to reach you on (does not have to be GovState email).

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* 4. What year are you?

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* 5. Which GovState club(s)/organization(s) are you affiliated with?

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* 6. Which Chicago sports outings are you interested in attending?

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* 7. I hereby consent to the use, publication, broadcast, telecast, distribution and circulation of my name, photograph, image, and/or likeness by Governors State University (GovState) in any GovState-sponsored product and/or publication used for recruiting, promotional, advertising, or commercial purposes, and shall include, but not limited to, the GSU website, newsletters, catalogs, trimester schedules, handbooks, and brochures. I further understand and agree that this picture release consent shall remain in full force and effect until canceled in writing ad in reasonable advance of any said publications.

I have read the foregoing Picture Release Consent. I fully understand its content and am voluntarily agreeing to this picture release consent as a free and voluntary act.

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