Fan Interview Release Consent Form
Please complete this form to provide your consent for the use and release of your interview materials.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Interview
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location of Interview
By signing below, I confirm that I have read and agree to the above release terms.
*
If the participant is under 18 years old, a parent or legal guardian must provide consent below. Parent/Guardian Name
First Name
Last Name
Parent/Guardian Signature (if applicable)
Submit Consent
Submit Consent
Should be Empty: