S -A -M -P- L- E

PROMOTIONAL ACTIVITIES RELEASE STATEMENT

(type on organization’s stationary)

Date

TO: Rob Bernardi

Director of Athletics

Nicholls State University

P.O. Box 2032

Thibodaux, LA 70310

SUBJECT: Promotional Activities Release Statement

(Name of Organization) agrees to abide by the provisions of NCAA Bylaw 12.5.1.1 (Promotional Activities) in its use of (name the student-athlete[s] or team)’s (name, photograph, or appearance) to support our (name /purpose of the activity). We are a (must be either: charitable or non-profit) organization and understand and agree that this activity will conform to the conditions listed below:

· The student-athlete(s) must have written approval from the Athletics Director to participate. Any personal appearance by the student-athlete requires approval from the student-athlete’s head coach.

· The activity does not involve co-sponsorship, advertisement or promotion by a commercial agency (other than registered trademarks or logos). Personal names, messages, and slogans will not be used.

· The student-athlete(s) will not miss class for the activity.

· All moneys derived from the activity will go directly to organizations charity or educational programs.

· No expenses will be paid to the student-athlete except legitimate reimbursement and only if the activity is within the state or within a 100 mile of the Nicholls State University campus.

· The student-athlete(s) name will not be utilized to promote the commercial ventures of the organization.

· Any commercial items with names or pictures of student-athletes will be sold only at the member institution at which the student-athlete is enrolled or outlets controlled by the charity (actual location of the charitable organization or site of the event).

This activity will involve the student-athlete (describe: i.e. making a personal appearance at the activity or providing on autographed item of apparel, equipment, or photograph; etc).

Sincerely,

Name

Officer’s Title