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Consent Form

This document is a consent, waiver, indemnity and release form for the Department of Education to use images and recordings of an individual for communications and public campaigns. It grants the DepEd rights to the materials, waives rights to inspect, approve or be compensated for use of the materials, and releases the DepEd from any liability related to use of the materials.

Uploaded by

Ryan Zaguirre
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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2K views1 page

Consent Form

This document is a consent, waiver, indemnity and release form for the Department of Education to use images and recordings of an individual for communications and public campaigns. It grants the DepEd rights to the materials, waives rights to inspect, approve or be compensated for use of the materials, and releases the DepEd from any liability related to use of the materials.

Uploaded by

Ryan Zaguirre
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CONSENT, WAIVER, INDEMNITY and RELEASE

I, ___________________________________, M/ F, _______ years of age, hereby grant permission to the


Department of Education (DepEd) and its representatives to make recordings of my voice and to take photographs and
/or videos in which I appear in, to be used for the communications and various public campaigns of the Agency be it in
print, broadcast, and/or electronic media, at the event and location stated below:

Production name/ Project title: ______________________________________________


End of School Year Rites 2022-2023

Location: ___________________________________________________________
Bacoor Elementary School Multipurpose Hall

I acknowledge that the DepEd owns all rights to these images and recordings. I further grant the DepEd and its
representatives the right to use, display, exhibit, reproduce, distribute, and create derivative works of these images and
recordings in any media now known or later developed.

I hereby waive any right to inspect or approve the use of the images or recordings or of any written derivatives. I
further waive all moral rights. I also waive any right to royalties or other compensation arising from or related to the use
of the materials.

I hereby release, defend, indemnify, and hold harmless the DepEd and its representatives from and against any
claims, damages, or liability arising from or related to the use of the images, recordings, or materials, including but not
limited to claims of defamation, invasion of privacy, or rights of publicity or copyright infringement, or any misuse,
distortion, blurring, alteration, optical illusion or use in composite form that may occur or be produced in taking,
processing, reduction or production of the finished product, its publication or distribution.

I am 18 years of age or older/ I am accompanied by my legal guardian, and I am competent to enter into this
contract/ NAME OF GUARDIAN: _ has legal authority to enter into this
contract. I have read this document before signing below, and I fully understand the contents, meaning and impact of this
consent, waiver, indemnity and release.

This consent, waiver, indemnity and release is binding on me, my heirs, executors, administrators and assigns.

______________________________________________ Date: _____/_____/_______


Signature mm dd yyyy

_______________________________________________ Date: ______/_____/_______


Signature over printed name of Parent /Guardian/ Teacher mm dd yyyy

Address: _________________________________________________________________________

Home phone: ______________________________ Mobile phone: ______________________________

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