Performer Release Form (Group)
This Performer Release is provided to Lewis & Clark College with respect to the following performance,
class or series of performances by an individual, group, band or other musical or theatrical performers
(collectively the "Performance"). If the Performance is by more than one individual, each performer should
sign one of these forms.
Title of Performance, class or group
1
:__________________________________
Date of Performance, or semester of class or time period applicable to performance group
2
:
______________________________________________
By signing below, I authorize and grant Lewis & Clark College, free of charge and without limitation, a
non-exclusive worldwide perpetual license to reproduce, photograph, record, video, publish, or otherwise
copy such Performance and to broadcast, display, reproduce, edit, exhibit and distribute the Performance
and any derivative works created from or with it, over television, cable, the Internet or any other
communication medium now existing or hereafter created. The granting of this license authorizes the use
and reproduction by Lewis & Clark, or anyone authorized by the College, of any and all photographs,
video, or other images taken for the purposes deemed appropriate by the College, without compensation.
I understand that these images may appear in any of the wide variety of formats and media now available
to the College or that may be available in the future, including but not limited to print, electronic / online
media, and video. I acknowledge that all images and videos are the property of Lewis & Clark College.
This authorization explicitly includes the use of my name, likeness, voice and/or biographical information
for the purpose of publicizing broadcast, telecast, distribution, publication or exhibition of the Performance
or portions thereof.
The Performance and any Performance materials are either: 1. my own original material; or 2. material for
which I have full authority to grant the rights set forth in this Release because the content is in the public
domain; or 3. licensed to Lewis & Clark College by performance licenses, in which case I assume no
responsibility for the sufficiency or maintenance of such a performance license, the responsibility for
which resides with Lewis & Clark College.
This Release supersedes all prior agreements pertaining to its subject matter and cannot be amended
without the written, signed agreement of an authorized representative of Lewis & Clark College.
2
For instance, if it is a single performance put the date. If it is a class and the intent is for this release to apply to all of the student’s
work in the class, insert the semester of the class. If the student is in a group or band, and the intent is for this form to apply to all
performances of the group or band during a certain time period, such as “the 2022-2023 academic year”, insert the time period.
1
For instance, if it is a single performance give the name or describe the performance; eg. “Bob Smith singing Sempre Libera”. If it
is a class or group, insert the name of the class or group.
Aug 2022
Signature ____________________Printed Name __________________________ Date: _____________
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Signature ____________________Printed Name __________________________ Date: _____________
Signature ____________________Printed Name __________________________ Date: _____________
Signature ____________________Printed Name __________________________ Date: _____________
Signature ____________________Printed Name __________________________ Date: _____________
Signature ____________________Printed Name __________________________ Date: _____________
Signature ____________________Printed Name __________________________ Date: _____________
Signature ____________________Printed Name __________________________ Date: _____________
Aug 2022
