VIDEO DOCUMENTARY INTERVIEW RELEASE FORM
My signature below will confirm my agreement with filmmaker/photographer/interviewer, (name of interviewer) _____________________________, and his/her legal representatives and assigns regarding the disposition of video documentary and photographs of interviews conducted with me (name of interviewee) , _____________________________________, on (date) _____________________ for ____________________________ (title of project).
I understand that the tapes both of me and transcripts (if transcribed) of the interview(s) will be maintained and made available indefinitely by the filmmaker/photographer/interviewer for such research, production (e.g., radio, television, film festivals, World Wide Web, exhibitions, related advertisements), and educational purposes as the filmmaker/photographer shall determine.
I hereby grant, and transfer to the filmmaker/photographer all rights, title, and interest in the interview and video documentary, including without limitation the literary rights and the copyright. I hereby release filmmaker/photographer/interviewer, and his/her legal representatives from all claims and liability relating to said documentary and photographs.
The filmmaker/photographer/interviewer agrees to retain the integrity of the interviewee's image and voice, neither misrepresenting the interviewee's words nor taking them out of context.
I attest that I have voluntarily agreed to be interviewed and that this document contains the entire and complete agreement concerning the use and preservation of my interview.
Signature of Interviewee: ______________________________
Date____________
Name (printed):______________________________________________________
Address: ____________________________________________________________
Telephone: __________________________
Signature of Interviewer: _______________________________
Date____________
Name (printed):_____________________________________________________