photo consent and release form         
                 
             

       
            The following is a standard photo consent and release form. It may 
            be adapted to fit local requirements.

            Photo Consent and Release
            I hereby consent to the use and publication by the Population 
            Council, Inc. of any photographs of me and to the Population 
            Council’s re–use and reproduction of such photographs in any form 
            and medium and for any purpose whatsoever. I agree that all such 
            photographs, all rights therein which include all worldwide rights, 
            and all negatives connected therewith shall be and remain the 
            Population Council's sole and exclusive property. This consent is 
            irrevocable. 
            I hereby release and discharge the Population Council, Inc. from any 
            and all claims and demands arising out of or in connection with the 
            use of such photographs, including but not limited to any claims for 
            defamation or invasion of privacy.
            I am of legal age and have read the foregoing and fully understand 
            the content thereof.
             
            Signature:_________________________________________________________________________________ 

            Date:_____________________________________________________________________________________ 

            Witness:__________________________________________________________________________________ 

             
             
            Photographer: 
            _____________________________________________________________________________ 

            Description of Footage:   
            _________________________________________________________________________________________ 

             
            _________________________________________________________________________________________