San Antonio's cultural experience museum..

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Consent Form

EXAMPLE
Photograph Consent Form

The undersigned hereby does authorize name/representative to photograph and/or copy photographs of:

____________________________________________________________
Name of Photograph Owner

The undersigned authorizes name/representative to use and display said photograph (s) and reproductions in any publication, multimedia production, display, advertisement, or online Internet production and transfers said photographs or reproductions as property of the XXXX.

The undersigned also agrees that name/representative may use name and/or biographical information about the undersigned individual or individual in the images.

In giving this permission, without fee or limitation whatsoever, and in consideration of the opportunity to participate in this activity, I agree to release, discharge, and hold harmless the name/representative or its employees , agents , and volunteers OR descendants and estates from any and all claims, actions, and demands of whatsoever nature, including but not limited to any claims of libel, defamation, or invasion of privacy, arising out of or in connection with the use of said photographs or reproductions.

Accepted and Agreed:
_________________________                                                     ______________________________
PRINT name of photo owner                                                                       Signature of photo owner

                 _____________________________________________________________
                     Address of photo owner           City/State/ZipCode                        Telephone

_________________________                                                         _____________________________
PRINT name of student                                                                                          Signature of student

                 _____________________________________________________________
                    Address of student                   City/State/Zip Code                        Telephone


 


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ŠUTSA's Institute of Texan Cultures, 801 S. Bowie St., San Antonio, TX 78205-3296, (210) 458-2330