Documentary Participation Consent & Media Release Form
Congolese Documentary Project — Lexington, KY
This project documents the experiences of members of the Congolese community living in Lexington, Kentucky. Through filmed oral history interviews, participants are invited to share their experiences of adapting to life in the U.S. — work, family life, language, faith, culture, and identity. The resulting documentary and oral history collection are intended for educational and cultural purposes.
Participation ideally involves a filmed interview of around 30 minutes, but can last as long as a participant feels comfortable. Participation is completely voluntary; participants can decline to answer any question or stop the interview at any time. With the participant's agreement, additional footage (B-roll) may also be filmed in locations such as the participant's home, workplace, church, community events, or other mutually agreed-upon locations.
I, _______________________________ (the "Participant"), hereby grant full permission to the Congolese Documentary Project (the "Project") and its filmmakers, producers, representatives, and assigns, to capture, record, edit, exhibit, publish, and distribute my name, likeness, voice, image, statements, and any biographical information I provide (collectively, the "Materials") in connection with the production of the documentary film currently titled "Congolese Documentary Project — Lexington, KY" (the "Film"). I understand that the Film may be exhibited, distributed, and broadcast in any and all media now known or hereafter developed, including but not limited to television, theatrical release, online streaming platforms, social media, and film festivals, throughout the world in perpetuity.
I acknowledge and agree that:
- The Project shall be the sole and exclusive owner of all rights, title, and interest in and to the Film and the Materials, including the copyright therein.
- I have no right to review or approve the finished Film or the use of the Materials.
- I waive any right to royalties, compensation, or other payment for the use of the Materials in connection with the Film.
- I release and discharge the Project, its filmmakers, and its representatives from any and all claims, demands, or causes of action that I may have arising out of or in connection with the use of the Materials, including but not limited to any claims for defamation, invasion of privacy, or right of publicity.
- I am at least 18 years of age (or, if I am under 18, I have obtained the consent of my parent or legal guardian).
This release shall be binding upon me and my heirs, legal representatives, and assigns. I have read this document and fully understand its contents.
Download the full consent form (.docx)Sign electronically
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Drawing is optional — your printed name above serves as your legal electronic signature.