Permission and Sample Release Forms

If possible, please have participants and tile makers sign some kind of permission form. Legally, if you want to use participants’ images for publicity you need to have them sign a waiver that all rights for reproduction will go to your organization as well as Center for Accessible Technology. Send a copy of this form back to us along with the completed tiles.

Here is a sample release form:

AUTHORIZATION TO RELEASE INFORMATION

I, __________________________, hereby give my permission for Center for Accessible Technology (and/or your organization name here) to use photographs, oral histories, poetry, journal writings, visual art and information about me and/or my family members for the DISABILITY MURAL display, promotions, marketing, fundraising, website, and recordings.

I understand that no other personal information regarding or identifying me will be used without my permission. In giving this consent, I release Center for Accessible Technology (and/or your organization name here) from any other obligation or liability owed to me in connection with any personal or ownership right I may have as a result of the sale, reproduction or use of the above-referenced identifying information.

Name_______________________

Date________________________

Address_____________________

Phone______________________

Email______________________