At Your Level - Kids Submissions Consent Form
Dear Families,

We would be grateful if you would take two minutes to sign and submit our audio, video, and photo release form. We need this release to consider your child’s submission to be featured in the At Your Level podcast and related materials.

Thank you!
Sign in to Google to save your progress. Learn more
Email *
I, the undersigned, hereby grant permission to At Your Level to use, publish, license, and distribute the below-named minor child’s name, photograph, likeness, voice, submitted idea, expressed opinion and created materials (collectively, “Materials”) for editorial, advertising, promotion, and publicity purposes in any and all formats throughout the world in perpetuity. *
I represent and warrant that I am the parent or legal guardian of the below-named minor child and have full right and authority to enter into this Release. *
I understand that these Materials may be used for a variety of purposes, as outlined above. I further understand and agree that neither I, nor the below-named minor, have any right to inspect or approve of the photographic, video, audio, or other products in which the Materials appear in whole or in part. *
I acknowledge that no compensation, fee, or royalty will be paid for the rights granted herein and that At Your Level shall own all right, title, and interest in the Materials and in the works in which some or all of them are incorporated. I will not seek compensation, on behalf of myself or any other party for such uses. *
I release At Your Level from any and all claims, demands, damages, and liabilities arising out of, or in connection with, the use or distribution of Materials, including but not limited to, claims of invasion of privacy, defamation, infringement of copyright, moral rights, or rights of publicity. *
I understand that this Release may not be revoked, and that it is binding on me, the below-named minor, our heirs, licensees, and assigns. *
This Release expresses the complete agreement of the parties and supersedes all prior communications, contracts, or agreements between the parties with respect to its subject matter, whether oral or written.
By signing below, I attest that I have read this Release and fully understand its contents. *
Name of Child *
Signature of Parent or Legal Guardian *
Date *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy