Photo/Video Release and Minor Consent Form All Participants need to fill this out.
PHOTO/VIDEO RELEASE:

I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or video tape without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording.

Photographic, audio or video recordings may be used for the following purposes:
• conference presentations
• educational presentations or courses
• informational presentations
• on-line educational courses
• educational videos
• advertising purposes

By signing this release I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet.

There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.

This release applies to photographic, audio or video recordings collected as a cast member of the Champaign Urbana Theatre Company's production of Hairspray.

MINOR CONSENT:

The minor named below has my permission to participate in the activities of the Champaign Urbana Theatre Company. I am aware that the Champaign Urbana Theatre Company has rules and regulations against minors using alcohol
and other unlawful drugs and will not tolerate any violations of those rules and regulations. I will encourage my son/daughter to abide by these rules and regulations of the Champaign Urbana Theatre Company, or he/she will forfeit the right to participate.

The Champaign Urbana Theatre Company will oversee the official activities on their assigned premises, but will not be held responsible for activities on other premises unless the activity is under the official sanction of said group (i.e. rehearsals at other locations, tours or performances, but not including cast parties off premises).


ALL FIELDS REQUIRE A RESPONSE. PLEASE TYPE NA IF NOT APPLICABLE TO YOU.


Email address
Participant's Last Name
Your answer
Participant's First Name
Your answer
Street Address/P.O. Box
Your answer
City
Your answer
Zip Code
Your answer
Phone
Your answer
Other phone
Your answer
Email Address (where all announcements/info will be sent)
Your answer
Emergency Contact
Your answer
Relationship to Participant
Your answer
Emergency Contact Phone
Your answer
By typing my name below, I acknowledge that I have completely read and fully understand the above release and consent form and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational or promotional purposes. I am eighteen years of age or older. (Participant please type name below.)
Your answer
FOR PARENTS/GUARDIANS OF MINORS ONLY. If this release is obtained from a participant under the age of 18, then the signature of the participant's parent or legal guardian is also required. By typing my name below, I acknowledge that I have completely read and fully understand the above release and consent form and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational or promotional purposes. (Parent/Guardian please type name below)
Your answer
Minor's Age
Your answer
Parent/Guardian Full Name (For Minors only)
Your answer
Parent/Guardian Place of Work (For Minors only)
Your answer
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