2019-2020 SRL Release Forms A1 - A2
I have agreed to participate in the PBS NewsHour’s Student Reporting Labs. I am participating as a producer of video reports for the Projects: No Labels Attached: Stereotypes and Misconceptions; HEALTH: How do we achieve our goals; Mental Health: Taking Care of You; Spotlight on Education; and/or Climate and Environment Solvers and/or as an interview subject appearing in the Projects: No Labels Attached: Stereotypes and Misconceptions; HEALTH: How do we achieve our goals; Mental Health: Taking Care of You; Spotlight on Education; and/or Climate and Environment Solvers. The produced video report and my participation as an Interviewee are collectively referred to herein as the “Contributions.” I understand that the Project, including my Contributions, may be distributed, exhibited, or broadcast worldwide, and may also be made accessible for use, in whole or in part, by download or streaming audio/video, or by any other means now known or hereafter developed; and that it may be published, distributed, licensed by any means and for use in any and all media (including, without limitation, electronic and digital media, whether now known or hereafter developed).

I agree that my name, likeness, voice and biographical material about me may be used in connection with the Project, the Contributions, as well as in publicity for the Project, PBS NewsHour, or PBS NewsHour Student Reporting Labs and NewsHour Weekend for promotional purposes. I further agree that the Contributions, my name, likeness, voice, and biographical material about me may be used by PBS, Greater Washington Educational Telecommunications Association, Inc., Corporation for Public Broadcasting and NewsHour Productions LLC (“NHP”) in connection with institutional promotion.

If a Producer, I represent and warrant that all material provided by me and represented or described as my own work will be original works and will be free of any liability or limitation on ownership. NHP will own the Contributions, and I grant to NHP all intellectual property rights I may have with respect to the Contributions or the use thereof.
I understand that I will not be paid for this participation.

Sign in to Google to save your progress. Learn more
Email *
First and last name *
I am over the age of 18 and consent to release the above information *
I am UNDER the age of 18 and my legal guardian or parent consents to the release of the footage and understands the above information
Clear selection
Name of Legal Guardian if UNDER 18
Email of Legal Guardian if UNDER 18
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of PBS NewsHour Student Reporting Labs. Report Abuse