Consent And Release Form

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PHOTO, VIDEO AND SOUND RECORDING RELEASE AND CONSENT FORM
By signing this Photo, Video and Sound Recording Release and Consent Form, you are irrevocably
giving permission to:
Your name or the name of your organization.
___________________________ (Producer) and their officers, agents, employees, successors,
licensees, and assigns to take and use photographs, video or sound recordings of you for the
following project:
Describe your project here. Use the same description in every form you provide to participants.
This is completely voluntary and up to you.
Your consent to the use of the photographs, video and sound recordings and your image, likeness,
appearance, and voice is for forever. You will not receive compensation for the use of your image,
likeness, appearance, and voice now or in the future. The Producer may use the photographs, video
and sound recordings containing your image, likeness, appearance and voice in any manner or
media, including use on web pages. The photographs, video and sound recordings may be used in
whole or in part, alone or with other recordings. The photographs, video and sound recordings may
be used for any educational, institutional, scientific or informational purposes whatsoever, but not
for any commercial uses. The Producer has the right and may allow others to copy, edit, alter,
retouch, revise and otherwise change the photographs, video and sound recordings at the Producer’s
discretion. All right, title, and interest in the photographs, video and sound recordings belong solely
to the Producer.
You further give permission to the Producer to use your name, biography, and any other personal
data, events, or other material in or in connection with any such uses of the photographs, video and
sound recordings.
I understand and agree to the conditions outlined in this photograph, video and sound recording
release and consent form. I irrevocably give consent to the Producer and the Producer’s officers,
agents, employees, successors, licensees, and assigns forever to make use of my image, likeness,
appearance, and voice in photographs, video and sound recordings as described above. I
acknowledge that I am fully aware of the contents of this release and am under no disability, duress,
or undue influence at the time of my signing of this instrument.
Printed Name of Participant
Signature of Participant
Date

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