Legal Release Form by pic18642

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									                                    CONSENT FORM

I, ___________________________________________________, agree to participate in
the project called “South Sudanese Cultural Preservation and Documentation
Project,” and consent to the audiotape/videotape recording of a song, performance, or an
interview between myself and the project's interviewer(s). I grant permission to Brandeis
University,the Sudanese Education Fund and the Sudanese Youth Association to use the
material from the taped interview(s) in a variety of ways. These may include an edited
audio tour of the community, a website, an exhibit, teaching materials, posters, book,
newspapers, radio programs, TV programs, public speaking engagements, or an archive
available to the public. The taped interview and any transcript that results from the
performance or interview will be the property of the Southern Sudan Cultural
Preservation and Documentation Project, Brandeis University, and the Sudan Education
Fund. Any photographs or other memorabilia loaned to the Southern Sudan Cultural
Archives will be returned to me, although copies may be used by the interviewer(s) for
the above-named purposes. I understand that I will not receive compensation for the use
of this material. I understand that this material is not intended to be used in any way that
would be slanderous or detrimental to anyone.


Signature__________________________________________Date______

Name (please print)__________________________________________________

Mailing Address______________________________________________________

Tel.No._______________________________________________________

Email: ________________________________________________

I consent to be identified by name in the project’s public materials (please circle)
YES          NO           I’M NOT SURE YET


Interviewer(s) for the Southern Sudan Cultural Archives

Name(s) (Print) __________________________________________________________

Signature(s)_____________________________________________________________

Date____________________________

								
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