NIL Disclosure Form

Email address *

Student Name (First, Last) *

Bryant & Stratton College Email address *

Bryant & Stratton College sports team *

Are you represented by an agent or attorney for this NIL opportunity?

(If yes, provide the name/phone/email/address of the agent or attorney)

Name of company compensating you for NIL

Company's phone number

Company's address

Company's contact person name

Company's contact person phone number

Company's contact person email

Description of the terms of the NIL agreement

Description of the activity (or activities) you will be participating in

Description of your obligations under the NIL agreement (what do you have to do and when)

How are you being compensated under the NIL agreement?

I acknowledge that Bryant & Stratton College or designee thereof, may review the accuracy of this information, and I consent to any investigation, review or audit of this NIL opportunity or anything related thereto. I acknowledge that inaccurate, incomplete or misleading disclosure or information, or failure to cooperate with Bryant & Stratton College in its evaluation of this NIL opportunity will be deemed to be a violation of College policy. *

I affirm that I am not receiving - and under this potential NIL opportunity will not receive - compensation that is conditioned or contingent on enrolling at, or continuing enrollment at Bryant & Stratton College, or on any specific athletic performance or achievement. *

* required field