General Publicity Release Form

Freedom Project wants to honor how you would like your image and voice to be used in Freedom Project and the broader community.

You have the right to withdraw consent at any time. Please allow us 72 hours to remove images or recordings of you.

New volunteers are asked to electronically sign the acknowledgement of this agreement during the orientation process (along with the Confidentiality Agreement and Acknowledgement of Handbook Reciept). If you are updating your records, you may be asked to electronically sign another document to verify this agreement.

Name

First Name

Last Name

Verify Email

If you do not want Freedom Project to use your photo, voice, or name in ANY way, check here.

I do not give Freedom Project permission to use my photo, voice, or name in any context.

I authorize Freedom Project to use my voice or image in the following formats:

Video recording

Audio Recording

Photograph

I authorize Freedom Project to use this recording for the following purpose(s):

Freedom Project website

Freedom Project YouTube page

Freedom Project Facebook page

Freedom Project brochures

I authorize the use of my voice or image at events where the following are present:

Freedom Project volunteers

Department of Corrections employees

People currently incarcerated

People formerly incarcerated

I authorize Freedom Project to identify me by:

First Name Only

Last Name Only

First and Last Name

Initials

Anonymously

Do you have any other requests? Please describe here.