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The following form is a sample release and authorization agreement to record a lecture. If you wish to record a lecture, you should have the person sign this agreement. Click here for the form in Word format.

You may also wish to visit the Guidelines for Using Photographs of People created by the University of Arizona Web Developers Group.

Disclaimer: This is a sample form, and may not be applicable to all situations. It is provided for informational purposes only, and should not be relied upon without first seeking advice from a licensed attorney. Reliance on this form shall not subject Western Kentucky University to any liability.

Release and Authorization Agreement

I, _____________________________________ understand, consent to, and agree that Western Kentucky University may reproduce my presentation or lecture for broadcast via a podcast, and that the University may utilize said podcast for educational, non-profit purposes in its sole discretion, including, but not limited to, use in University and non-university publications, and that Western Kentucky University shall own and retain all rights to said podcast.

Signed________________________________

Date________________________

Witness________________________________

Date________________________

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Last Modified September 26, 2007

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