Sample Waiver For Group Events Photo/video Release Form

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Sample waiver for GROUP EVENTS
Photo/Video release form
I hereby consent to and authorize the use and reproduction by REPORTER’S NAME of any and all photography
and/or videography that has been taken of me this day for any purpose, without compensation to me. All digital
image and/or video files are wholly owned by the REPORTER’S NAME, who reserves the right to use these
images and/or video for publication on the online publication, BLOG URL.
I hereby acknowledge that I am 18 years of age or older and have read and understood the terms
of this release.
Full name (please print)___________________Signature______________ Phone__________ Date______
Full name (please print)___________________Signature______________ Phone__________ Date______
Full name (please print)___________________Signature______________ Phone__________ Date______
Full name (please print)___________________Signature______________ Phone__________ Date______
Full name (please print)___________________Signature______________ Phone__________ Date______
Full name (please print)___________________Signature______________ Phone__________ Date______
Full name (please print)___________________Signature______________ Phone__________ Date______
Full name (please print)___________________Signature______________ Phone__________ Date______
Full name (please print)___________________Signature______________ Phone__________ Date______
YOUR NAME AND CONTACT INFO AT THE BOTTOM
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Sample waiver for INDIVIDUALS AND/OR MINORS
For adults
I hereby consent to and authorize the use and reproduction by REPORTER’S NAME of any and all photographs
and/or video that have been taken of me this day for any purpose, without compensation to me or my assignees.
All images and digital files are owned by the REPORTER’S NAME, who reserves the right to use these
photographs and/or video for the online publication, BLOG URL. I hereby report that I am 18 years of age or
older and have read and understood the terms of this release.
Name (please print): ___________________________________________________ Signed:
____________________________________________ Date: ____________
Witness (please print): __________________________________________________ Signed:
____________________________________________ Date: _____________
For minors (children and youth under 18)
I hereby consent to and authorize the use and reproduction by REPORTERS NAME of any and all photographs
and/or video that have been taken of ____________________, a minor child in my custody as parent or
guardian, for any purpose, without compensation to me, the child or assignees. All images and digital files are
owned by the REPORTER’S NAME, who reserves the right to use these photographs and/or video for the
online publication, BLOG URL. I hereby report that I am 18 years of age or older and have read and understood
the terms of this release.
Name (please print): ___________________________________________________ Signed:
____________________________________________ Date: ____________
Witness (please print): __________________________________________________ Signed:
____________________________________________ Date: _____________
YOUR NAME AND CONTACT INFO AT THE BOTTOM

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