Publication, Video and Website Consent and Release Agreement

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 clients of WorkSource Spokane, the Spokane Resource Center, the Next Generation Zone, 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 signed form indicates agreement that the subject’s name, picture, art, written work, voice, verbal statements and/or likeness (video or still) (hereafter referred to as “images”) may appear in the Council’s publications, videos and/or website, or in print, social or broadcast media. 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 subject’s images shall be used only for public relations, public information, event or project promotion, publicity and/or instruction. If the subject, 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 non-profit use and distribution of such images for purposes deemed suitable by the Spokane Workforce Council, unless I make my wishes to the contrary known.
Is the subject a minor (less than 18 years old)?*

YesNo
Subject Name

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

Clear
Date

MonthDayYear
Date
Parent/Guardian Release for Minor

If the subject 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