Arts Integration Solutions
General Video and Photography Release Form

 Arts Integration Solutions (AiS) is a non-profit 501(c) charitable education organization that provides professional development training in arts integration to teachers at your school.  The teachers in turn, use arts integration in their lessons on an everyday basis.  From time to time, AiS photographs, videotapes, films, records audio and engages in other documentation of the actual classroom practice of arts integration with teacher and students. AiS also photographs, videotapes, films, audio records and engages in other documentation of events such as Arts Integration Intensives, in-services, tailored events and train the trainer facilitator sessions.    

I hereby grant permission to AiS to videotape, film, photograph, record or otherwise document my participation in the classroom practice of arts integration; my participation in any professional development session such as an in-service, Arts Integration Intensive, Arts Integration Academy or other tailored event; and my participation in a train the trainer session for facilitators.

I hereby grant permission to AiS to use or publicly display my photograph, video image, or audio clip on the AiS website(s) or other official AiS publications without further notice.  I acknowledge AiS’s right to crop, edit, or treat the photograph, video or audio clip at its discretion.  I understand that once my photograph, video image, or audio clip is published on a web site, it can be downloaded by any computer user. 

I understand that personal information such as my name and biography will only be published with my permission if acknowledged below. My address, telephone numbers will not be disclosed by AiS.

Therefore, I agree to indemnify, defend, and hold harmless AiS and it’s board of directors, employees, agents, successors, and assignees from and against any and all claims and liabilities resulting from any publishing.

PERMISSION IS GRANTED for the use described above.

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PRINTED NAME              

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SIGNATURE

By checking this box, I authorize the use of my name and biography in any published material created by AiS.

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DATE

 

Please print this page and retain for your own records.