Video Release Form


User Experience Group
University Information Technology Services, Indiana University
Video Release Form
The signature below indicates my permission for University Information
Technology Services User Experience Group of Indiana University to use video
footage recorded during the usability session conducted for
(project) __{project name}___ (date) {month} ________, 200{year},
in which I served as a participant.
My name will not be reported in association with session results nor will my name
be included on the video footage. This video footage may be used for the
following purposes:
Analysis of research and reporting of results
Conference presentations
Educational presentations
Informational presentations
I will be consulted about the use of the video recording for any purpose other than
those listed above.
There is no time-limit on the validity of this release nor is there any geographic
specification of where these materials may be distributed.
This release applies to video footage collected as part of the usability session
listed on this document only.
I have been given a blank copy of this release form for my records.
Name (please print):


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