Open Media Foundation Consent and Release Form for Youth Media Participation
Open Media Generation is a free, weekly after-school program for Denver Metro youth, aged 11-21. The program is designed to involve students in community activism, organizing and social justice issues while learning to use video and new media production skills. Each month, Open Media Generation produces Spotlight on Students (SOS) on Denver Open Media - Denver's Public Access Television Station. SOS is a live studio production that incorporates studio interviews, short video segments that the youth produce in advance and PSAs related to the show's topic.

Each month, one team (6-8 youth) chooses a topic they want to explore. With each episode the youth alternate between the roles of director, producer, host, audio, camera, floor manager and technical director. The program is entirely youth-directed, with minimal support or guidance provided by the Open Media Foundation Staff. Youth research the topic and interview local experts in business, nonprofit organizations, community groups or schools that engage youth around the chosen topic.

The youth decide what type of footage is needed from the field, either "voice of the people" street interviews, on-site footage of interviewees, PSAs or interviews with additional youth or organizations. All field footage is edited in order to be incorporated into the live show and to add another conversational dimension to the live studio interviews.

This training helps youth to both realize their capacity as leaders and to recognize and respect peer leaders. Finally, Open Media Generation fuels creativity, problem solving skills and helps participants develop unique job skills that are increasingly valuable in the digital age.

The Open Media Foundation supports this youth program as a service to the community. We do so at a financial loss, providing training and equipment to the youth without payment from the participants or their families. If you would like your child to participate in this event, please complete, sign, and return the following Consent and Release Form, acknowledging that they are participating at their own will and with your consent. As parent or legal guardian, you and your child remain fully responsible for the actions and conduct of your child.

Image/Sound/Media Release
I grant to Open Media Foundation the right to create, use, reproduce, assign and/or distribute photographs, films, video, digital images and sound recordings of this participant or materials they create at any time without prior notification for any purpose. All participants are granted unrestricted use of the recordings for any purpose, provided they fall within the creative commons license under which the recordings are released.
Transportation
I understand that OMF does not provide transportation to the participants of the group. At times, the youth may elect to separate into smaller production groups and go out into the community to film interviews or community events. OMF does not provide transportation, nor do we coordinate such transportation, so if you do not wish for your child to provide or receive transportation from other participants, we encourage you to have that conversation with your child. OMF assumes no liability for the transportation of youth group participants.
Participation- Liability and Release
As the parent/guardian of the minor child named below, I give permission for him/her to participate in Open Media Generation. OMF is not responsible for the personal property of your child during the program. Please encourage your child to keep track of their belongings at all times. Additionally, by signing I release the OMF from any liability or responsibility for any injuries or damages he/she may cause or suffer as a result of participation. Participants in OMG are responsible for any damages or loss of equipment in their care. If you do not accept this responsibility, your child will not have to access to video production equipment at OMF.
Medical Considerations
Please list any conditions or allergies that we should be aware of.
Your answer
Youth's Name
Your answer
Youth's Age
Your answer
Print Name (Parent/Gaurdian)
Your answer
Relationship to Youth
Your answer
Street Address
Your answer
City
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State
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Postal Code
Your answer
Primary Phone of Parent/Guardian
Your answer
Primary Email of Parent/Guardian
Your answer
What is your youth's racial or ethnic identity (check all that apply)
What is the primary language of your youth?
How would you describe your youth's gender?
Is your youth living with a mental or physical disability?
Please use "other to describe disability"
Required
Which of the following categories best represents your household income level?
Indicate your Education level
Required
What is the primary way your family accesses the internet?
How did you hear about us?
What skill level is your child in each category?
Please rate their comfort level 1-10.
1
2
3
4
5
6
7
8
9
10
Technology
Teamwork/Social Skills
Artistic/Creativity
Interpersonal Communication
Public Speaking
Parent/Gaurdian (signature)
Type your name to e-sign
Your answer
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