Video Release for Seniors VIDEO RELEASE FORM FOR Seniors Branches Between Generations – A Podio Studio Production Video Recording Consent (Seniors) Participant's Name * Participant's Name First Name First Name Last Name Last Name Phone Number * Email Address * This form must be signed by the participant prior to filming. * I, the undersigned, hereby give permission to participate in the video podcast project titled Branches Between Generations, produced by Podio Studio and distributed via Telus Optik TV and the Storyhive YouTube Channel. By signing this release, I acknowledge and agree to the following: Recording and Distribution I will be recorded using both video and audio equipment during my interview. These recordings may be edited and published publicly across various platforms, including television and online media. Optional Support A support person or legal representative may be present in the monitoring room during the interview, where a live camera feed can be observed. Review and Editing Timeline I will receive an uncut version of the interview within 72 hours of the recording session. I agree to review the footage and inform the producer of any content I wish to exclude from the final cut within 14 days. A rough cut of the pilot episode will be provided in mid-August 2025 for final feedback. August 28, 2025 is the final production deadline. After this date, no further edits or changes will be possible. Exclusive Rights and Ownership I understand and agree that all footage recorded as part of this project, including audio, video, and any related digital materials, shall become the exclusive property of Clinton Nellist, producer of Podio Studio. Content Usage Permission I grant Clinton Nellist the exclusive, irrevocable right to use, reproduce, modify, publish, distribute, and display this content in whole or in part, in any format or medium, now known or hereafter developed. I understand that no additional permissions or approvals will be required for the future use of these materials. Participant Acknowledgment Participation in this project is voluntary. I understand that no financial compensation will be provided. Participant's Full Name * Signature * signature keyboard Clear Date * If you have any questions, please contact:Clinton NellistProducer,clinton@podio.ca250-208-3451 Captcha Submit If you are human, leave this field blank.
