Middlebury

 

Recording Consent & Copyright Release Form

Middlebury College preserves and disseminates recordings of select events sponsored by the College. This form must be filled out where indicated and the required I AGREE boxes must be checked in order for Media Services to make an audio or video recording of any speaker, presenter, or participant. If an event includes multiple participants who are recorded, each must submit a separate release form.

Fields marked with a red asterisk (*) are required.

Note: Event organizers must also fill out the Event Recording Release Form, available at go.middlebury.edu/recording

Basic Information
:

If possible, please include a brief description of your presentation.

If you have a digital photograph available (JPEG preferable), you may upload it here. This photo can then be be added to the description of your presentation in the Middlebury Digital Lecture Archive.

Speaker Contact Information (Email address required)
Address
Phone
Email
Department Sponsorship (required if applicable)

Middlebury academic dept., program, or organization that is sponsoring the event

Name of person from the sponsoring dept., program, or organization

Email of contact person from sponsoring dept., program, or organization. Confirmation email will also be sent to this person.

Agreement Clause

By checking I AGREE, you are giving consent for Middlebury College to record, retain, and distribute your presentation under the terms selected above. You are indicating your agreement to create and sign this electronic record in accordance with Chapter 20 of Title 9 of the Vermont Statutes Annotated.