Model release form

Model release for FUSE video project

The following form relates to video provided for the FUSE video project! The video will answer the question: What would your dream school experience be like? What things would be different from school now? The video is being collected for a student-led project aimed at improving school experiences for diverse young people.
Student's name*

First NameLast Name
E-mail*
example@example.com
Terms and Conditions

I grant permission to intertwine to use my likeness/the likeness of my child or ward in the photographs or videos I am submitting.

I understand that these materials are intended to create a learning kit for teachers as part of the FUSE prorgam but may also be used for various purposes to promote FUSE itself, including but not limited to: advertising, marketing, promotion, and distribution.

I hereby waive any right to inspect or approve the finished product wherein my likeness/the likeness of my child or ward appears. I also waive any claims to compensation or royalties arising from the use of these materials.

I assert that I own the rights to the photographs or videos which I am submitting and I am licensing these rights to intertwine in perpetuity in all jurisdictions and across all media.
Do you agree to the terms above?*

I certify that I am over 18 years of age and have the legal authority to grant this release on my own behalf.I certify that I am over 18 years of age and have the legal authority to grant this release on behalf of my minor child or ward.I am under 18 years of age, and I understand that my parent or legal guardian will be contacted to review and consent to this release on my behalf.
Name of Parent or Guardian signing

First NameLast Name
Comments
Should be Empty:

Model release for FUSE video project