City Voices, City Visions Digital Video Composing Project¹

RELEASE FORM

I hereby release to the City Voices, City Visions Digital Video Composing Project team rights to my image, likeness, and sound of my voice, as recorded on videotape on (date or dates) ________________________ for the purpose of __________________________ _____________________________________________________[name of project].

I understand that portions of this digital videotape recording may be used for educational purposes, including publication on the CVCV website and thereafter the program may be otherwise available.

I hereby release any and all claims against CVCV arising in connection with the usage of my name, my image, likeness, and voice.

I acknowledge that this release is firm and final and I understand that CVCV may proceed to use this digital videotape.

The undersigned in this release desires to assist in the work of CVCV by making the name, image, likeness, and voice of the undersigned available.

Participant’s Full name____________________________________ Date_____________

Signature:_________________________________________

Guardian (if participant is under 18 yrs. of age)________________________________________

Address: ______________________________________________________________

Phone number:_________________________________________________________

Witness: ______________________________________ Date: ____________________