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Video Recording Consent Form Template

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Conditions
(Please note, this example form does not constitute a fully written and usable video recording release. The content here is merely for example purposes.)

I hereby grant the XYZ COMPANY, its directors, officers, employees, agents, and designees (collectively “XYZ COMPANY”) non-revocable permission to capture my image and likeness in videotapes, motion pictures, recordings, or any other media (collectively “Images”). I acknowledge that XYZ COMPANY will own such Images and further grant the XYZ COMPANY permission to copyright, display, publish, distribute, use, modify, print and reprint such Images in any manner whatsoever related to XYZ COMPANY business, including without limitation, publications, advertisements, brochures, web site images, or other electronic displays and transmissions thereof. I further waive any right to inspect or approve the use of the Image by the XYZ COMPANY prior to its use. I forever release and hold the XYZ COMPANY harmless from any and all liability arising out of the use of the Images in any manner or media whatsoever, and waive any and all claims and causes of action relating to use of the Images, including without limitation, claims for invasion of privacy rights or publicity.

I hereby warrant that I am eighteen (18) years old or more and competent to contract in my own name or, if I am less than eighteen years old, that my parent or guardian has signed this release form below. This release is binding on me and my heirs, assignees and personal representatives.
Name of Individual
Revocation: Please check one of the two following options
I understand that my video recording(s) may never be revoked.
I understand that my consent may be withdrawn after written confirmation sent to _________.
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If you’re looking to gain consent for a video recording, then you need the Video Recording Consent Form Template from WPForms.

This template covers all of the information and consents needed for the release of video recordings, including a change in ownership..

What Does a Video Recording Consent Form Include?

On this template, you’ll find the following:

  • Conditions of the video recording consent
  • The individual’s information and contact details
  • Description of the video recording(s)
  • Revocation, or terms of cancelation of the consent
  • Required signature and date

We’ve included a revocation clause on this template because it’s vital to have on most consent forms. The revocation allows the releasee to choose between never revoking the consent or withdrawing consent in writing.

And for Pro and Elite WPForms subscribers, we’ve included a signature box to ensure full consent and agreement to the terms listed on the form.

As always, the Video Recording Consent Form Template is fully customizable. That way, you can include whatever specific terms and conditions you need for your form or add secondary signatures, releases, and more.

Get started with WPForms today to create and customize your own Video Recording Consent Form. Signing up with WPForms gives you access to this and hundreds of other pre-made templates.