Model Release From

Publication, Video and Website Consent and Release Agreement

We seek permission to use your photo, name, voice, statement, written work, and/or art.
The Spokane Workforce Council occasionally asks participants of Spokane Workforce Council, WorkSource Spokane, the Next Generation Zone, Talent Solutions by WorkSource Spokane, and/or members of the public to be a part of publicity, publications and/or public relations activities, which may include representation in the media.

The PARTICIPANT grants permission to Spokane Workforce Council and its assigns, licensees, and sublicensees, permission to use PARTICIPANT'S image or likeness in any and all forms of media for commerical purposes, advertising, trade, personal use, or any and all other uses. Therefore, Spokane Workforce Council may use PARTICIPANT's likeness and image on Spokane Workforce Council's or the centers mentioned for media purposes. The participant’s name, picture, art, written work, voice, verbal statements and/or likeness (video or still) (hereafter referred to as “images”) may appear in publications, videos and/or website, in print, social or broadcast media, or provided to third parties under the Spokane Workforce Council discretion. These images may or may not personally identify the subject. The subject also agrees that:

· No money shall be paid.

· Consent and release have been given willingly.

· The images may be used in the future.

The Spokane Workforce Council and its partners agree that the participant’s images shall be used only for public relations, public information, event or project promotion, publicity and/or instruction. If the participant, or in the case of a minor child, parent or guardian wish to rescind this agreement, they may do so at any time with written notice.
Agreement

I authorize the Spokane Workforce Council to use my name, voice, verbal statements and/or any photographs, film, digital recording or videotape that may contain my likeness, for publicity or informational purposes. This includes the editing, duplication, reproduction, copyright, representation in the media, exhibition, broadcast, posting on the Council’s websites or social media sites, WorkSource-branded sites and/or other nonprofit use and distribution of such images for purposes deemed suitable by the Spokane Workforce Council, unless I make my wishes to the contrary known.
Staff Member
Center
Staff Member Name & Title
If applicable, please provide project details.
Please sign that you explained and detailed the release to the participant.

Clear
Participant
Is the participant a minor (less than 18 years old)?*

YesNo
Participant Name

First NameLast Name
Participant Email
example@example.com
Participant Phone Number
Please enter a valid phone number.
Signature

Clear
Date

MonthDayYear
Date
Parent/Guardian Release for Minor

If the participant is a minor child (less than 18 years old), complete the following section.
Minor Name

First NameLast Name
Guardian Name

First NameLast Name
Guardian Signature

Clear
Phone Number
Please enter a valid phone number.
Date

MonthDayYear
Date
FOR ADMIN USE ONLY - UPLOAD HARD COPY MEDIA RELEASE FORMS HERE
Should be Empty:

Publication, Video and Website Consent and Release Agreement

Parent/Guardian Release for Minor