Talent Release Form printable pdf download

Talent Release Form

THE UNIVERSITY OF TEXAS AT DALLAS

Talent Release Form

For valuable consideration, I do hereby authorize The University of Texas at Dallas, and those

acting pursuant to its authority to:

a. Record my participation and appearance on videotape, audiotape, film, photograph or

any other medium.

b. Use my name, likeness, voice and biographical material in connection with these

recordings.

c. Exhibit or distribute such recording in whole or in part without restrictions or

limitation for any educational or promotional purpose, which The University of Texas

at Dallas, and those acting pursuant to its authority, deem appropriate.

d. Exhibit or distribute any written documentation in whole or in part without restrictions

or limitation for any educational or promotional purpose, which The University of

Texas at Dallas, and those acting pursuant to its authority, deem appropriate.

This release shall remain in effect unless revoked in writing.

Name:

___________________________________________________________

Address:

___________________________________________________________

Phone No.: ________________________

Email: ___________________________

Signature: ______________________________________

Date: _______________

Parent/Guardian Name:

______________________________________________

( if under 18 )

Parent/Guardian Signature: ________________________

Date: _______________

( if under 18 )

Witness Signature: _______________________________

Date: _______________

The University of Texas at Dallas

P.O. BOX 830688

Richardson, Texas

(972) 883-2111

Talent Release Form