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2017 video consent release form printable

Consent and Release Form Having been fully informed of the 2026

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The document is a Video Consent and Release Form that grants permission to a legal entity or organization to use an individual's image, likeness, and interview statements for various media purposes without compensation. It includes sections for consent regarding interviews, filming, and the use of personal information in publications and media. The form also allows for parental consent if the individual is a minor.

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Click ‘Get Form’ to open it in the editor.
Begin by filling in the legal entity or organization name where indicated. This identifies who will be using your image and likeness.
Review the permissions listed and initial next to each applicable option: (a) for video reproduction, (b) for using your name, and (c) for quotes from interviews.
Provide your full name, signature, address, and date at the bottom of the form to confirm your consent.
If you are signing on behalf of a minor, ensure that you complete the section for parent or legal guardian's signature and print name.
If required, have an organizational representative read the consent form aloud to you and sign where indicated.

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2017 video consent release form template

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