"Photo / Video / Interview Waiver and Release Form" - Arizona

Photo / Video / Interview Waiver and Release Form is a legal document that was released by the Arizona Department of Housing - a government authority operating within Arizona.

Form Details:

  • The latest edition currently provided by the Arizona Department of Housing;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Arizona Department of Housing.

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PHOTO / VIDEO / INTERVIEW WAIVER AND RELEASE FORM
The Arizona Department of Housing (ADOH) communicates its work through a variety of platforms
including but not limited to photographs, print and online publications, brochures, annual reports, social
media, websites, e-newsletters, video recordings, presentations, advertisements, promotional materials
and the media.
I, _______________________________________ give permission to the Arizona Department of Housing to:
(Print first and last name)
Photograph or videotape me (still or moving images).
Record my voice.
Use my full name.
Quote or paraphrase all or any portion of an interview I provide to ADOH staff.
Copyright, reproduce, distribute, publish, and/or otherwise use all or any part of photographs
and/or motion pictures and/or voice recordings and/or written/spoken statements taken of me for
use in any or all media including print, broadcast, presentations and the Internet.
I hereby waive and
release the Arizona Department of Housing and those acting pursuant to its
authority from liability, claims and demands for any liability to me or any third parties resulting from
the use of the foregoing or violation of any personal or propriety right I may have in connection with
such use, including any and all claims for libel, defamation, or invasion of privacy.
Furthermore, I acknowledge that I have voluntarily agreed to the foregoing and I agree that I will not be
compensated for my participation or use of my interview, photo, video or voice recording. This waiver
and release shall be binding upon my heirs, successors, assigns and personal representatives, without
regard to whether it is expressly acknowledge in any instrument of succession or assignment.
I am eighteen (18) years of age or older, and I have authority to grant this waiver and release.
I have read and fully understand the terms of this release:
_______________________________________
_______________________________
Signature
Date
________________________________________
_______________________________
Email
Telephone Number
PHOTO / VIDEO / INTERVIEW WAIVER AND RELEASE FORM
The Arizona Department of Housing (ADOH) communicates its work through a variety of platforms
including but not limited to photographs, print and online publications, brochures, annual reports, social
media, websites, e-newsletters, video recordings, presentations, advertisements, promotional materials
and the media.
I, _______________________________________ give permission to the Arizona Department of Housing to:
(Print first and last name)
Photograph or videotape me (still or moving images).
Record my voice.
Use my full name.
Quote or paraphrase all or any portion of an interview I provide to ADOH staff.
Copyright, reproduce, distribute, publish, and/or otherwise use all or any part of photographs
and/or motion pictures and/or voice recordings and/or written/spoken statements taken of me for
use in any or all media including print, broadcast, presentations and the Internet.
I hereby waive and
release the Arizona Department of Housing and those acting pursuant to its
authority from liability, claims and demands for any liability to me or any third parties resulting from
the use of the foregoing or violation of any personal or propriety right I may have in connection with
such use, including any and all claims for libel, defamation, or invasion of privacy.
Furthermore, I acknowledge that I have voluntarily agreed to the foregoing and I agree that I will not be
compensated for my participation or use of my interview, photo, video or voice recording. This waiver
and release shall be binding upon my heirs, successors, assigns and personal representatives, without
regard to whether it is expressly acknowledge in any instrument of succession or assignment.
I am eighteen (18) years of age or older, and I have authority to grant this waiver and release.
I have read and fully understand the terms of this release:
_______________________________________
_______________________________
Signature
Date
________________________________________
_______________________________
Email
Telephone Number