Photo/Video Release Form - Student

PHOTO AND VIDEO RELEASE FORM

Student/Minor Participant

ORGANIZATION INFORMATION

[ORGANIZATION NAME] ("Organization")

Address: [ADDRESS]
Phone: [PHONE]
Email: [EMAIL]
Website: [WEBSITE]

STUDENT INFORMATION

PARENT/GUARDIAN INFORMATION

SECTION 1: GRANT OF PERMISSION

I, the undersigned parent/legal guardian, hereby grant to [ORGANIZATION NAME], its employees, agents, representatives, successors, and assigns, the right and permission to:

1.1 Types of Media

☐ Photograph
☐ Video record
☐ Audio record
☐ Film
☐ Create digital images of

the above-named student ("Student") in connection with the Student's participation in Organization's programs and activities.

1.2 Covered Activities

This release covers photographs, videos, and recordings taken during:

☐ Regular program activities and classes
☐ Special events and performances
☐ Field trips and excursions
☐ Competitions and tournaments
☐ Graduation and award ceremonies
☐ Promotional photo/video sessions
☐ All activities organized by Organization
☐ Specific event: [SPECIFY]

SECTION 2: AUTHORIZED USES

2.1 Permitted Uses

I grant permission for the photographs, videos, and recordings to be used for the following purposes:

Digital/Online:
☐ Organization's website
☐ Organization's social media accounts (Facebook, Instagram, Twitter, YouTube, TikTok, etc.)
☐ Email newsletters and communications
☐ Online advertising
☐ Virtual and digital presentations

Print Materials:
☐ Brochures and flyers
☐ Posters and banners
☐ Newsletters and magazines
☐ Newspaper and print advertisements
☐ Direct mail materials
☐ Yearbooks and memory books

Other Media:
☐ Television and broadcast media
☐ Press releases and media kits
☐ Instructional and training materials
☐ Documentary or promotional videos
☐ Presentations at conferences or events
☐ Internal communications
☐ Archive and historical records

Use Selection:
☐ I grant permission for ALL uses listed above
☐ I grant permission for SELECTED uses only (check applicable boxes above)

2.2 Duration of Use

☐ Perpetual: This release remains in effect indefinitely
☐ Limited Term: This release is valid for [NUMBER] years from the date signed
☐ Single Event: This release applies only to [EVENT NAME/DATE]

SECTION 3: LIMITATIONS AND RESTRICTIONS

3.1 Name Usage

☐ Organization MAY use Student's first name with images
☐ Organization MAY use Student's first name and last initial only
☐ Organization may NOT use Student's name with images
☐ Organization may NOT identify Student's school or location

3.2 Context Restrictions

Organization agrees that images will be used:
☐ In a positive and respectful manner
☐ Consistent with the Organization's mission and values
☐ Not in any manner that would be embarrassing or harmful to Student

3.3 Specific Restrictions (Optional)

Please note any specific restrictions on use:
_________________________________
_________________________________

SECTION 4: RIGHTS AND ACKNOWLEDGMENTS

4.1 Rights Granted

By signing this release, I understand and agree that:

☐ Organization owns all rights to the photographs, videos, and recordings created
☐ Organization may edit, alter, or modify the images as it deems appropriate
☐ Organization may use images in combination with other images, text, or graphics
☐ Organization may sublicense images to affiliated organizations
☐ This release is binding on myself, my child, and our heirs and assigns

4.2 Compensation

☐ I understand that no compensation will be paid for the use of images
☐ I waive any right to royalties or other compensation for use of images
☐ I waive any right to inspect or approve the finished product

4.3 No Guaranteed Use

☐ I understand that Organization is not obligated to use any images
☐ Selection of images for use is at Organization's sole discretion

SECTION 5: RELEASE OF CLAIMS

5.1 Release

I hereby release and discharge [ORGANIZATION NAME], its employees, agents, representatives, successors, and assigns from any and all claims, demands, and causes of action arising from or related to:

☐ The taking of photographs, videos, or recordings
☐ The use, reproduction, or publication of images
☐ Any blurring, distortion, alteration, or use in composite form
☐ Any claims for defamation, invasion of privacy, right of publicity, or similar claims

5.2 Indemnification

I agree to indemnify and hold harmless Organization from any claims arising from the use of images as authorized by this release.

SECTION 6: REVOCATION

6.1 Right to Revoke

☐ I understand that I may revoke this release at any time by providing written notice to Organization
☐ Revocation will only apply to future uses of images
☐ Organization is not required to remove or recall materials already created or distributed
☐ Revocation does not affect images already posted online (though Organization may choose to remove them)

6.2 Revocation Process

To revoke this release, written notice must be sent to:

[ORGANIZATION NAME]
[ADDRESS]
[EMAIL]

SECTION 7: SPECIAL CIRCUMSTANCES

7.1 Social Media Considerations

☐ I understand that images posted on social media may be shared by others
☐ Organization cannot control third-party sharing once images are posted
☐ I have been informed of potential risks of online image publication

7.2 Third-Party Platforms

☐ Images may be subject to the terms of service of third-party platforms (Facebook, Instagram, etc.)
☐ Organization is not responsible for platform policies or changes

7.3 Media/Press

If images may be shared with media:
☐ I consent to media/press use of images
☐ I DO NOT consent to media/press use of images

SECTION 8: CONSENT SELECTION

Please select one option:

☐ FULL CONSENT: I grant permission for Organization to photograph, video, and record my child and use such media for all purposes described above.

☐ LIMITED CONSENT: I grant permission for Organization to photograph, video, and record my child, subject to the specific limitations I have noted above.

☐ NO CONSENT: I do NOT grant permission for Organization to photograph, video, or record my child for promotional or public use.

SECTION 9: ACKNOWLEDGMENTS

By signing below, I acknowledge that:

☐ I have read and understand this Photo/Video Release Form
☐ I am the parent or legal guardian of the Student named herein
☐ I have the legal authority to grant this release on behalf of the Student
☐ I am signing this release voluntarily
☐ I have had the opportunity to ask questions
☐ I understand this is a legal document

SIGNATURES

Parent/Guardian

I hereby grant the photo and video release as indicated above.

Signature: _________________________________ Date: _____________

Printed Name: _________________________________

Relationship to Student: _________________________________

Student (if 18 or older)

If Student is 18 or older, Student may sign for themselves:

Signature: _________________________________ Date: _____________

Printed Name: _________________________________

FOR ORGANIZATION USE ONLY

ALTERNATIVE FORMAT: QUICK CONSENT FORM

For organizations needing a simpler format, the following abbreviated version may be used:

PHOTO/VIDEO CONSENT - SHORT FORM

Student Name: _________________________________

Grade/Program: _________________________________

Parent/Guardian Name: _________________________________

I give [ORGANIZATION NAME] permission to photograph and video my child and use such images for the organization's website, social media, and promotional materials.

☐ YES, I give permission
☐ NO, I do not give permission

Name may be used: ☐ Yes ☐ First name only ☐ No

Parent/Guardian Signature: _________________________________ Date: _________

This Photo and Video Release Form template is provided for informational purposes only and does not constitute legal advice. Consult with a qualified attorney in your jurisdiction before use. Privacy laws regarding minors' images vary by state and may have specific requirements for educational settings.