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Release Form - Adult
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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: _______________________________