Form JD-ES-338 "Photograph/Media Consent and Release" - Connecticut

What Is Form JD-ES-338?

This is a legal form that was released by the Connecticut Superior Court - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2018;
  • The latest edition provided by the Connecticut Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form JD-ES-338 by clicking the link below or browse more documents and templates provided by the Connecticut Superior Court.

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Download Form JD-ES-338 "Photograph/Media Consent and Release" - Connecticut

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PHOTOGRAPH/MEDIA
STATE OF CONNECTICUT
CONSENT AND RELEASE
SUPERIOR COURT
JD-ES-338 New 10-18
www.jud.ct.gov
ADA NOTICE
The Judicial Branch of the State of Connecticut
complies with the Americans with Disabilities Act
(ADA). If you need a reasonable accommodation in
accordance with the ADA, contact a court clerk or an
Instructions
ADA contact person listed at www.jud.ct.gov/ADA.
If the participant is under the age of 18, this form must be signed by a parent or guardian.
Name of participant
Address
City
State
Zip code
I grant to the State of Connecticut Judicial Branch (hereinafter “Judicial”), my permission to record my
image or visual likeness, my name and/or my voice (the “Personal Information”) by film, video, audio,
digital and/or any other media (the “Works”), and to use, publish, copyright and reproduce such Personal
Information in any format (e.g., print publications, video tapes, CD-ROM, DVD-ROM, multimedia and
Web content) for any lawful purpose, including, but not limited to, program publicity, instruction,
illustration, research, governmental reporting or Web content.
I release and agree to indemnify and hold Judicial, its agents, employees, public officials and
representatives harmless from any and all claims, causes of action, demands for damages, or liabilities
of any kind, including the reasonable costs to defend such actions regardless of whether such action is
successful or not, brought by any person or entity whatsoever, arising from the use of the Personal
Information.
I waive any right to inspect or approve any Works that may be created using the Personal Information
and waive any claim with respect to the eventual use to which the Personal Information may be applied.
I understand and agree that Judicial is and shall be the exclusive owner of all right, title, and interest,
including copyright, in the Works.
I am 18 years of age or older and acknowledge that I have read this authorization form and agree to its
terms.
Date signed
Signed (Participant)
If the participant is under the age of 18, consent must be by a parent or guardian, as follows:
I attest that I am the parent or guardian of
(name of minor child)
and that I have the authority to authorize Judicial to use the minor child's Personal Information. I give my
consent on behalf of this person in accordance with the terms of this Consent and Release form.
Name of Parent/Guardian
Date signed
Signed (Parent/Guardian signature)
Print Form
Reset Form
PHOTOGRAPH/MEDIA
STATE OF CONNECTICUT
CONSENT AND RELEASE
SUPERIOR COURT
JD-ES-338 New 10-18
www.jud.ct.gov
ADA NOTICE
The Judicial Branch of the State of Connecticut
complies with the Americans with Disabilities Act
(ADA). If you need a reasonable accommodation in
accordance with the ADA, contact a court clerk or an
Instructions
ADA contact person listed at www.jud.ct.gov/ADA.
If the participant is under the age of 18, this form must be signed by a parent or guardian.
Name of participant
Address
City
State
Zip code
I grant to the State of Connecticut Judicial Branch (hereinafter “Judicial”), my permission to record my
image or visual likeness, my name and/or my voice (the “Personal Information”) by film, video, audio,
digital and/or any other media (the “Works”), and to use, publish, copyright and reproduce such Personal
Information in any format (e.g., print publications, video tapes, CD-ROM, DVD-ROM, multimedia and
Web content) for any lawful purpose, including, but not limited to, program publicity, instruction,
illustration, research, governmental reporting or Web content.
I release and agree to indemnify and hold Judicial, its agents, employees, public officials and
representatives harmless from any and all claims, causes of action, demands for damages, or liabilities
of any kind, including the reasonable costs to defend such actions regardless of whether such action is
successful or not, brought by any person or entity whatsoever, arising from the use of the Personal
Information.
I waive any right to inspect or approve any Works that may be created using the Personal Information
and waive any claim with respect to the eventual use to which the Personal Information may be applied.
I understand and agree that Judicial is and shall be the exclusive owner of all right, title, and interest,
including copyright, in the Works.
I am 18 years of age or older and acknowledge that I have read this authorization form and agree to its
terms.
Date signed
Signed (Participant)
If the participant is under the age of 18, consent must be by a parent or guardian, as follows:
I attest that I am the parent or guardian of
(name of minor child)
and that I have the authority to authorize Judicial to use the minor child's Personal Information. I give my
consent on behalf of this person in accordance with the terms of this Consent and Release form.
Name of Parent/Guardian
Date signed
Signed (Parent/Guardian signature)
Print Form
Reset Form