Permission and Release Form for Audio Recording Lecture

Event: __________________________________________________________________________________

Please checkmark Yes/No for all questions 1-2.  This form also requires your signature on page two.

 

1.      I am willing to have my presentation available on Centre’s website, iTunes University, or any other 

   on-line video streaming service managed by Centre College.

                               Yes ________

                   No  ________ 

 

2.      I am willing to have my presentation available on any Centre’s web presence,, only if access is limited

   to individuals who work/attend Centre College.

                   Yes ________

                   No  ________ 

Centre College may audiotape the session in which you appear as a speaker to make it available to those who are unable to attend the 
presentation or for archiving purposes. Before we can duplicate and disseminate the audio of the session, we require a signed release from you.

The undersigned does hereby give consent to and authorize Centre College and its licensees to make recordings and transcriptions to use, 
and reuse the program and recordings in whole or in part, in any media now or hereafter known.   

It is understood that no substantive editing of the content will be done. Any editing will be of a mechanical nature including but not limited to attaching leaders, 
deleting pauses, and such. 

It is hereby acknowledged that any opinions expressed are the sole responsibility of the undersigned and in no matter reflect policies or opinions of the Centre College.

It is understood that in the event that any materials used in this presentation contain the work of other individuals or organizations 
(including any copyrighted musical compositions or excerpts thereof), it is the responsibility of the undersigned to secure any necessary permissions and/or licenses.  
Small performing rights licenses must be secured for public performance of any copyrighted musical composition.

_____________________________________________________________________                                              

Name of Presenter                                                               

____________________________________________                                                  ____________________

Signature                                                                                                            Date

I decline to be audiotaped because: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________