Corwin file reference (name and date of project/event):
Rev. 10.03.19
YES STUDENT PARTICIPANT FILMING RELEASE AND PERMISSION FORM
Corwin Press, Inc.
2455 Teller Road, Thousand Oaks, CA 91320
During the course of the Youth Equity Stewardship program (the “Program”), Corwin Press, Inc. (“Corwin”)
intends to shoot video footage and take photographs during Program activities, which may be used for
educational, commercial and/or marketing/promotional purposes, containing photographs, video scenes,
interviews, and/or events in which my child, named below, performs, participates, is portrayed, and/or appears
recognizably and/or may contain my child’s intellectual and/or creative works (“Works”). Corwin may also collect
samples of my child’s Works during the course of the Program.
For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, I hereby
authorize Corwin, its imprints, affiliates, licensees, assignees, and authorized agents (collectively, the “Corwin
Parties”) to photograph, record, transcribe and/or otherwise reproduce and depict my child’s name, voice, visual
likeness, and statements made by my child (collectively, “Likeness”) and Works, and to exhibit, distribute, transmit
and/or otherwise utilize any and all such reproductions containing my child’s Likeness and Works in any manner
whatsoever, altered as Corwin may see fit, in any and all media now or hereafter known, throughout the world in
perpetuity. For the avoidance of doubt, I hereby transfer and assign to Corwin any copyright I may own in any
such photographs, audio-video footage, transcriptions, and/or reproductions containing my child’s Likeness and
Works. The rights granted hereunder are granted for the entire world and shall inure in perpetuity.
Further, I grant to Corwin the non-exclusive, perpetual right and permission to include the Works within and in
conjunction with its print and multimedia educational products, including for marketing/promotional purposes in
support of such products, in all languages and formats now known or later developed, throughout the world.
I hereby forever release the Corwin Parties from any claims that may arise regarding the use of my child’s
Likeness and Works, including, without limitation, any claims of rights of publicity, invasion of privacy, portrayal of
false light, defamation, infringement of moral rights, or copyright infringement.
I hereby warrant that I am over the age of 18, have the right to contract in my child’s name, and have read and
understand this Student Participant Filming Release and Permission Form (“Release”) and all of its terms.
This Release sets forth the entire agreement between the parties, and supersedes any prior agreements or
understandings, oral or written. This Release is governed by the laws of the State of California, without regard to
principles of conflict of laws.
As the parent/legal guardian of the minor aged child named below, I consent to all of the terms and conditions of
this Release.
Child’s Name:
School Name:
City and State of School:
Parent/Guardian Name:
Parent/Guardian Signature:
Parent/Guardian Address:
Date:
FORM 3 – YES Student Participant Filming release and Permission Form
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