Middle Tennessee State University Athletic Compliance ... - Sites
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Middle Tennessee State University Athletic Compliance Office Student-Athlete Promotional Activities Request Form This form, when signed and approved by the Athletic Department, allows the Middle Tennessee State University to grant permission for a studentathlete's name, picture, or identity to be used in a charitable community service or promotional activity.
NCAA Bylaws 12.5 Promotional Activities; 12.5.1 Permissible; 12.5.2 Non-permissible
Name of Sponsoring Activity
Name of Contact Person
Address (street, city, state, ZIP code)
Phone Number
Agency Type: Institutional, Charitable, or Educational
Date, Time, and Site of Event
Event Description
Name of Coach(es), Student-Athlete(s), or Team Requested
Describe the proposed activity/request (attached information if available):___________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Name(s) of involved student athlete(s): _______________________________________________________________________ ________________________________________________________________________________________________________ Is this a fundraising event? Yes ☐ No ☐ If Yes, who will receive the proceeds and what will the proceeds be used for? ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Will a student-athletes name, picture, personal appearance or involvement be used in any advertising or promotion of the activity? Yes ☐ No ☐ If Yes, how will the student-athlete be used in the advertising or promotion? ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Will a student-athlete(s) receive expenses/gifts (e.g., meals, transportation) associated with their involvement in the activity? Yes ☐ No ☐ If Yes, indicate what the student-athlete(s) will receive: ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Will there be any commercial sponsorship of the event? Yes ☐ No ☐ If Yes, how is the commercial entity involved in this activity? ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Will there be any advertisements or promotions by a commercial agency or sponsor? Yes ☐ No ☐ If Yes, what type of advertising or promotion will be used? ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Will the involved student-athlete miss class?
Yes ☐
No ☐
Page |2 STUDENT-ATHLETE CERTIFICATION In signing this form, I acknowledge that I have read and agree to abide by all NCAA regulations regarding my proposed involvement in this activity. _____________________________________________________________________________________________________ Signature of MTSU Student-Athlete Date _____________________________________________________________________________________________________ Signature of MTSU Student-Athlete Date _____________________________________________________________________________________________________ Signature of MTSU Student-Athlete Date
FOR OFFICIAL USE ONLY Does this activity meet the requirements of NCAA Bylaw 12.5.1.1?
Yes ☐ No ☐
Signature of Promotional Request Contact or Athletic Staff:
Date:
Athletic Compliance Office:
Date:
PROMOTIONAL ACTIVITIES INVOLVING STUDENT-ATHLETES NCAA Bylaw 12.5.1.1 permits a charitable or educational agency to use a student-athlete's name, picture, or appearance to support its charitable or educational activities, provided the following are met: A. B. C.
D.
E. F. G. H. I.
J.
The student-athlete receives written approval to participate from the director of athletics (or his or her designee who may not be a coaching staff member), subject to the limitations on participants in such activities as set forth in Bylaw 17; The specific activity or project in which the student-athlete participates does not involve sponsorship, advertisement or promotion by a commercial agency other than through the reproduction of the sponsoring company's officially registered regular trademark or logo on printed materials such as pictures, posters or calendars. The company's emblem, name, address and telephone number may be included with the trademark or logo. Personal names, messages and slogans (other than an officially registered trademark) are prohibited; The name or picture of a student-athlete with remaining eligibility may not appear on an institution's printed promotional item (e.g., poster, calendar) that includes a reproduction of a product with which a commercial entity is associated if the commercial entity's officially registered regular trademark or logo also appears on the item; The student-athlete does not miss class; All moneys derived from the activity or project goes directly to the member institution, member conference or the charitable, educational or nonprofit agency; The student-athlete may accept actual and necessary expenses from the member institution, member conference or the charitable, educational or nonprofit agency related to participation in such activity; The student-athlete's name, picture or appearance is not utilized to promote the commercial ventures of any nonprofit agency; Any commercial items with names, likenesses or pictures of multiple student-athletes (other than highlight films or media guides per Bylaw 12.5.1.8) may be sold only at the member institution at which the student-athlete is enrolled, institutionally controlled (owned and operated) outlets or outlets controlled by the charitable or educational organization (e.g., location of the charitable or educational organization, site of charitable event during the event). Items that include an individual studentathlete's name, picture or likeness (e.g., name on jersey, name or likeness on a bobble-head doll), other than informational items (e.g., media guide, schedule cards, institutional publications), may not be sold; and The student-athlete and an authorized representative of the charitable, educational or nonprofit agency sign a release statement ensuring that the student-athlete's name, image or appearance is used in a manner consistent with the requirements of this section.
Middle Tennessee State University Athletic Compliance Office Student-Athlete Promotional Activities Request Form This form, when signed and approved by the Athletic Department, allows the Middle Tennessee State University to grant permission for a studentathlete's name, picture, or identity to be used in a charitable community service or promotional activity.
NCAA Bylaws 12.5 Promotional Activities; 12.5.1 Permissible; 12.5.2 Non-permissible
Name of Sponsoring Activity
Name of Contact Person
Address (street, city, state, ZIP code)
Phone Number
Agency Type: Institutional, Charitable, or Educational
Date, Time, and Site of Event
Event Description
Name of Coach(es), Student-Athlete(s), or Team Requested
Describe the proposed activity/request (attached information if available):___________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Name(s) of involved student athlete(s): _______________________________________________________________________ ________________________________________________________________________________________________________ Is this a fundraising event? Yes ☐ No ☐ If Yes, who will receive the proceeds and what will the proceeds be used for? ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Will a student-athletes name, picture, personal appearance or involvement be used in any advertising or promotion of the activity? Yes ☐ No ☐ If Yes, how will the student-athlete be used in the advertising or promotion? ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Will a student-athlete(s) receive expenses/gifts (e.g., meals, transportation) associated with their involvement in the activity? Yes ☐ No ☐ If Yes, indicate what the student-athlete(s) will receive: ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Will there be any commercial sponsorship of the event? Yes ☐ No ☐ If Yes, how is the commercial entity involved in this activity? ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Will there be any advertisements or promotions by a commercial agency or sponsor? Yes ☐ No ☐ If Yes, what type of advertising or promotion will be used? ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Will the involved student-athlete miss class?
Yes ☐
No ☐
Page |2 STUDENT-ATHLETE CERTIFICATION In signing this form, I acknowledge that I have read and agree to abide by all NCAA regulations regarding my proposed involvement in this activity. _____________________________________________________________________________________________________ Signature of MTSU Student-Athlete Date _____________________________________________________________________________________________________ Signature of MTSU Student-Athlete Date _____________________________________________________________________________________________________ Signature of MTSU Student-Athlete Date
FOR OFFICIAL USE ONLY Does this activity meet the requirements of NCAA Bylaw 12.5.1.1?
Yes ☐ No ☐
Signature of Promotional Request Contact or Athletic Staff:
Date:
Athletic Compliance Office:
Date:
PROMOTIONAL ACTIVITIES INVOLVING STUDENT-ATHLETES NCAA Bylaw 12.5.1.1 permits a charitable or educational agency to use a student-athlete's name, picture, or appearance to support its charitable or educational activities, provided the following are met: A. B. C.
D.
E. F. G. H. I.
J.
The student-athlete receives written approval to participate from the director of athletics (or his or her designee who may not be a coaching staff member), subject to the limitations on participants in such activities as set forth in Bylaw 17; The specific activity or project in which the student-athlete participates does not involve sponsorship, advertisement or promotion by a commercial agency other than through the reproduction of the sponsoring company's officially registered regular trademark or logo on printed materials such as pictures, posters or calendars. The company's emblem, name, address and telephone number may be included with the trademark or logo. Personal names, messages and slogans (other than an officially registered trademark) are prohibited; The name or picture of a student-athlete with remaining eligibility may not appear on an institution's printed promotional item (e.g., poster, calendar) that includes a reproduction of a product with which a commercial entity is associated if the commercial entity's officially registered regular trademark or logo also appears on the item; The student-athlete does not miss class; All moneys derived from the activity or project goes directly to the member institution, member conference or the charitable, educational or nonprofit agency; The student-athlete may accept actual and necessary expenses from the member institution, member conference or the charitable, educational or nonprofit agency related to participation in such activity; The student-athlete's name, picture or appearance is not utilized to promote the commercial ventures of any nonprofit agency; Any commercial items with names, likenesses or pictures of multiple student-athletes (other than highlight films or media guides per Bylaw 12.5.1.8) may be sold only at the member institution at which the student-athlete is enrolled, institutionally controlled (owned and operated) outlets or outlets controlled by the charitable or educational organization (e.g., location of the charitable or educational organization, site of charitable event during the event). Items that include an individual studentathlete's name, picture or likeness (e.g., name on jersey, name or likeness on a bobble-head doll), other than informational items (e.g., media guide, schedule cards, institutional publications), may not be sold; and The student-athlete and an authorized representative of the charitable, educational or nonprofit agency sign a release statement ensuring that the student-athlete's name, image or appearance is used in a manner consistent with the requirements of this section.
