Urban Villages Initiative Tooklit

CONSENT TO PHOTOGRAPH, FILM OR VIDEOTAPE AN INDIVIDUAL

EVENT:

LOCATION:

DATE:

Name:

Age (Optional):

I hereby consent to the participation in the use of quotes, and the taking of photographs, film or video tape footage.

I also grant the right to edit, use, and reuse said products for non-profit purposes including use in print, on the internet, and all other forms of media. I also hereby release the Urban Villages Initiative and its employees from all claims, demands, and liabilities whatsoever in connection with the above.

Signature of Parent/Guardian (if Individual is under 18):

Date:

Address of Parent/Guardian:

OR

Signature of Individual (if 18 or over) :

Date:

Urban Villages Media Toolkit | 13