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Photo/Video Release Form

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Photo/Video Release Form
Photo/Video Release Form
Photo/Video Release Form
AUTHORIZATION TO USE PHOTOGRAPHS AND/OR AUDIO-VISUAL
I, ___________________________________________, hereby authorize
_________________________________________ (photographer/videographer), the
Corporation for National and Community Service (Corporation), or
_________________________________________ (project or project sponsor) to
use, reproduce, and/or publish photographs and/or video that may pertain to me—
including my image, likeness and/or voice without compensation. I understand that
this material may be used in various publications, public affairs releases, recruitment
materials, broadcast public service advertising (PSAs) or for other related endeavors.
This material may also appear on the Corporation's or project sponsor's Internet Web
Page. This authorization is continuous and may only be withdrawn by my specific
rescission of this authorization. Consequently, the Corporation or project sponsor may
publish materials, use my name, photograph, and/or make reference to me in any
manner that the Corporation or project sponsor deems appropriate in order to
promote/publicize service opportunities.
Description of Material (Photos/Audio-Visual):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
__________________________________________ Signature
________________________ Date
Photo/Video Release Form