Video Interview Release Consent Form

I hereby grant permission to (“Producer”) to record, use and distribute video, audio, and/or photographic images of me (the “Interviewee”) taken during my participation in the video interview. I understand that these recordings may be used for educational, promotional, and informational purposes, in any medium and format, and that there is no time or geographic limitation on their use by the Producer.

I confirm that the information I provide in the interview may be edited and published at the discretion of the Producer. I waive any right to inspect or approve the finished product in which my likeness appears.

I release and discharge the Producer from any claims or liability by virtue of any use of my image or statements, including without limitation any claims for libel or invasion of privacy.

Interviewee Information

Parent/Guardian (If under 18)