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AUNTIE OWL PRODUCTIONS
Video Consent & Release Form
-ADULTS-
First Name
Email
Last Name
Date of Birth
Without expectation of compensation or other remuneration, now or in the future, I hereby give my consent to Auntie Owl Productions and its affiliates and agents, to use my image and likeness and/or any interview and statements from me in its publications, advertising, or other media activities (including the Internet). This consent includes, but is not limited to: Permission to interview, film, photograph, tape, or otherwise make a video reproduction of me and/or record my voice; Permission to use my name; and Permission to use quotes from the interview(s) (or excerpts of such quotes), the film, photograph(s), tape(s) or reproduction(s) of me, and/or recording of my voice, in part or in whole, in its publications, in newspapers, magazines and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for educational and awareness. This consent is given in perpetuity.
Initials
Submit
THANKS! YOU'RE ALL SET!
AUNTIE OWL PRODUCTIONS
Video Consent & Release For
m
-MINORS-
First and Last Name of Guardian
Guardian Email
I, the parent or legal guardian(s) of the below-named minor child, hereby consent to and give this permission to Auntie Owl Productions on behalf of such minor child
Name of Minor
Minor Date of Birth
Without expectation of compensation or other remuneration, now or in the future, I hereby give my consent to Auntie Owl Productions and its affiliates and agents, to use my image and likeness and/or any interview and statements from me in its publications, advertising, or other media activities (including the Internet). This consent includes, but is not limited to: Permission to interview, film, photograph, tape, or otherwise make a video reproduction of me and/or record my voice; Permission to use my name; and Permission to use quotes from the interview(s) (or excerpts of such quotes), the film, photograph(s), tape(s) or reproduction(s) of me, and/or recording of my voice, in part or in whole, in its publications, in newspapers, magazines and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for educational and awareness. This consent is given in perpetuity.
Initials
Submit
THANKS! YOU'RE ALL SET!
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