Session Recording Release Form
Please complete this form to provide your consent for session recording and the use of recorded 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.
Session Title or Name
*
Session Date
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Session Organizer/Host Name
*
Type of Recording (Select all that apply)
*
Audio
Video
Screen Sharing
Other
Intended Use of the Recording
*
Internal Review/Training
Public Sharing (e.g., website, social media)
Marketing/Promotional Materials
Research/Education
Other
Signature (Please sign below to confirm your consent)
*
Date of Consent
*
-
Month
-
Day
Year
Date
Submit Consent
Submit Consent
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