KHAN Program
OSP Release

Fill out the release form below. It will automatically sent to your advisor.

2022-23 Release Form

Khan Program OSP Release Form 2022/23
I, the undersigned, have agreed to participate in the College Board’s Access to Practice program. I hereby give my full and complete permission for:

The College Board to share my name and online practice usage and data (“SAT Practice data”) with Access College Foundation. I acknowledge that the College Board and Khan Academy will rely on this permission and that the College Board, in its sole discretion, may decide whether or not to use my SAT Practice data and/or share my name and the SAT Practice data with my district.

The College Board and its agents to use my feedback, survey responses (“Information”).
The College Board and its agents to photograph me and make audio (sound) and video (picture) recordings of me and/or use my name, image, statements, and any video or audio recordings of me that have been provided to the College Board. For the purposes of this release, these photographs and recordings are referred to as “Images.”

I understand that based on my selections above, my participation in this program and other Information as well as my Image, may be used by the College Board, Khan Academy and their affiliates, (collectively referred to as “College Board”). I also acknowledge that the College Board will rely on this permission and that the College Board, in its sole discretion, may decide whether or not to use the Information and/or Images. I will not assert a claim that such use of Information or Images as stated above, is a violation of my rights. I further understand and agree that I am hereby waiving all rights and claims to ownership of the College Board materials in which my Information or Image may appear. In addition:

A. If indicated above, I grant the College Board the right to use, edit, reproduce, broadcast, publish, exhibit, publicize, and otherwise distribute, without compensation to me, any Images, Information and any statements and/or comments that I make, on the College Board website, in videos, print materials, and in other formats and mediums now known or here after developed. The rights granted to the College Board are perpetual and worldwide.

B. I expressly release and indemnify the College Board and its officers, employees, agents and designees from any and all claims, known or unknown, arising out of or connected with the above granted uses and permission.

This agreement is the full and complete understanding between the College Board and me and I have had adequate time to read this document carefully and to ask any questions that I may have.

Student Name
Student Name
Required if participant is under 18 years old.
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