Jake Menghini Historical Museum Video Release Form

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This form is for contributors and/or volunteers of the Jake Menghini Historical Museum at 105 Odill Drive, Norway, Michigan 49870 to add his/her videos from events taken place at the museum. The contributor(s) and/or volunteers release the videos to the Jake Menghini Historical Museum for publication to its website and/or social media platforms without request of monies from the museum. Video credits will remain with the author of the video and shared by the museum only. The museum is not liable for video assets being modified by social media platforms and/or website providers. This form is to provide consent to the museum from the contributor(s) and/or volunteer(s).

Email *

Please provide your first and last name. *

Please provide your phone number where we can reach you (with area code). *

I, (first and last name above) am a *

Volunteer of the museum

Contributor to the museum

Other:

I, (first and last name above) provide consent to the museum to use my video on its social media platforms and/or website. *

Yes

I, (first and last name above) understand that my video(s) and/or image(s) may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. *

Yes

Additionally, I, (first and last name above), waive any right to royalties or other compensation arising or related to the use of my image(s) and/or video(s) or recording(s). *

Yes

I, (first and last name above) have a YouTube channel. It can be found here (enter full hyperlink). If none, type N/A. *

Please provide the Jake Menghini Historical Museum event name, date of event, and location of event of your video that you would like to add to the museum's YouTube channel. *

Do you (first and last name above) have written permission and/or consent form(s) with all the individuals in your video(s)? *

Yes and I can provide a copy of the written consent form(s) to the museum.

Privacy Policies

The Jake Menghini Historical Museum utilizes social media platforms whereas YouTube (Google) privacy policy can be found here, Intuit Mailchimp privacy policy can be found here, HubSpot's privacy policy can be located here, Facebook's Privacy Policy can be found here, and Instagram's privacy policy is located here.

The Jake Menghini Historical Museum will use your first and last name as the author of the video and/or media unless explicitly requested by the author of this form to remove its name in writing by sending an email requesting the removal of your first and last name for credit of authoring the video(s) and/or media. Please send your consent to remove your personal data e.g., first and last name from social media by emailing us here.

I, (first and last name above) understand that I can withdraw the consent I have given at any time. However, I understand that the museum may have limits into shared and reproduced such as that the museum can not undo what is already done. I have the right to correct or rectify any information that I may find to be incorrect. Send requests to admin@jakemenghinimuseum.org. Subject: Request to withdraw consent. Please provide sufficient details for the consent to remove data e.g., first and last name, which video (title and published date), and/or the hyperlink where the video is located.

Signing and/or Submitting Release

By submitting this release, I, (first and last name above) understand this permission signifies that photographic, audio, and/or video recordings of me may be electronically displayed via the Internet or in the public educational setting.

I, (first and last name above) will be consulted about the use of the photographs and/or video recording for any purpose other than presentations, online/Internet videos, media, public educational setting, online publishing ads, print marketing advertisements, service demonstration, video and television media advertisements, and/or News (Press).

There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.

This release applies to photographic, audio, and/or video recordings collected as part of the sessions listed on this document only.

By submitting this release, I, (first and last name above) acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational purposes.

Send me a copy of my responses.

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