Release Form - Adult

RELEASE AGREEMENT FOR ADULT

“Cultural Maps, Cultural Tours”

Thank you for participating in the “Cultural Maps, Cultural Tours” project. By signing the form below, you give your permission for the Center for the Study of Upper Midwestern Cultures to:

  • Use recordings or photographs made during this event for educational purposes, including web and print publications and exhibitions.
  • Deposit these materials in the Center’s public archives where they can be made available to researchers and the public for scholarly or educational purposes.

By giving your permission, you do not give up any copyright or other rights that you may hold.

I agree to the uses of these materials described above except for any restrictions listed below.

Informant/Interviewee:

Signature ___________________________________________

Printed name ________________________________________

Date ____________

Address ____________________________________________

Researcher/Interviewer:

Signature ___________________________________________

Printed name ________________________________________

Date ____________

Address ____________________________________________

Restrictions:

Restrictions in effect until: _______________________________

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This page last updated on November 5, 2002