Here is a copy of a standard photo video consent form that can be used for most productions. There is a downloadable word file at the bottom if you’d like the more concrete template.
Video Consent and Release Form
Without expectation of compensation or other remuneration, now or in the future, I hereby give my consent to [legal entity/organization], its affiliates and agents, to use my image and likeness and/or any interview statements from me in its publications, advertising or other media activities (including the Internet). This consent includes, but is not limited to:
(a) Permission to interview, film, photograph, tape, or otherwise make a video reproduction of me and/or record my voice;
(b) Permission to use my name; and
(c) Permission to use quotes from the interview(s) (or excerpts of such quotes), the film, photograph(s), tape(s) or reproduction(s) of me, and/or recording of my voice, in part or in whole, in its publications, in newspapers, magazines and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for educational and awareness.
This consent is given in perpetuity, and does not require prior approval by me.
Signature of Videographer/Photographer
Date Signature of Organization