Video Release Form printable pdf download

Video Release Form

User Experience Group

University Information Technology Services, Indiana University

Video Release Form

The signature below indicates my permission for University Information

Technology Services User Experience Group of Indiana University to use video

footage recorded during the usability session conducted for

(project) __{project name}___ (date) {month} ________, 200{year},

in which I served as a participant.

My name will not be reported in association with session results nor will my name

be included on the video footage. This video footage may be used for the

following purposes:

Analysis of research and reporting of results

Conference presentations

Educational presentations

Informational presentations

I will be consulted about the use of the video recording for any purpose other than

those listed above.

There is no time-limit on the validity of this release nor is there any geographic

specification of where these materials may be distributed.

This release applies to video footage collected as part of the usability session

listed on this document only.

I have been given a blank copy of this release form for my records.

Date

Name (please print):

Signature

Address:

Video Release Form