Media Release Form (for Students)

Create Document

A media release form for students is used to request permission to use a student’s name, image, voice, or likeness in recordings done by their school. The student’s parent or guardian must sign the form to establish that they won’t hold the school responsible for any harm that might arise from any third party claims or litigation.

Media Release Form (for Students)

A media release form for students is used to request permission to use a student’s name, image, voice, or likeness in recordings done by their school. The student’s parent or guardian must sign the form to establish that they won’t hold the school responsible for any harm that might arise from any third party claims or litigation.

Create Document
PDF
Word (.docx)
OpenDocument
PDF
Word (.docx)
OpenDocument

Last updated May 6th, 2024

Document Preview

A media release form for students is used to request permission to use a student’s name, image, voice, or likeness in recordings done by their school. The student’s parent or guardian must sign the form to establish that they won’t hold the school responsible for any harm that might arise from any third party claims or litigation.

Downloads: 677
  1. Home »
  2. Liability Forms »
  3. Media »
  4. Student

Sample

Download: PDF, MS Word, OpenDocument

MEDIA RELEASE FORM (FOR STUDENTS)

Student: [STUDENT NAME] (the “Student”)

School: [SCHOOL NAME] (the “School”)

I, [PARENT/GUARDIAN NAME], the parent/guardian of the Student named above, hereby agree to allow my child to be photographed, video recorded, and/or voice recorded and for their name, image, likeness, and voice to be used in photographs, videos, publications, internet, news, and social media and web pages for special projects or publicity by the School.

I am aware that the Student may be asked a variety of questions concerning the School and school-related activities and programs, and that the contents of the interview may be published or aired publicly. I understand that the Student will be under the supervision of a school staff member during the interview or photo session. There may not be school staff supervision, however, if the photographs, video recordings, or voice recordings are part of a general background scene in which my child is not identified.

The Student reserves the right to refuse to answer any questions or participate in any discussions that make them feel uncomfortable or embarrassed. Additionally, the Student or the supervising school agent reserves the right to terminate the interview or photo or video session at any time for any reason.

I understand that neither the School nor the news media has any obligation to air or publish the image, photos, video recordings, or voice of the Student. I also understand that neither I nor the Student will receive any monetary compensation for the rights granted herein, and I understand that the Student’s appearance or the use of their voice in any digital or printed media format does not confer any ownership rights on me or the Student.

If by reason of the Student’s statements and actions in the interview, photos, images, video or voice recordings, or the materials furnished to the Student by anyone other than the School for the same, there is any claim or litigation involving any charge by third parties of violation or infringement of their right, I agree to indemnify and hold harmless the School, its staff, the Board of Education and its licensees and assignees from liability, loss, or expenses arising from such claim or litigation.

Parent/Guardian’s Signature: _______________________ Date: _____________
Print Name: ____________________________