Video Use Consent and Release Form

  • By agreeing and attaching this video file, I hereby grant to Population Reference Bureau the right to reproduce, display, and disseminate worldwide and in perpetuity, in any traditional or electronic media format, my film footage, video footage, and/or still photograph(s) without any further financial obligation.
  • I confirm that PRB’s use of this film footage, video footage, and/or still photograph(s) as permitted herein will not infringe on the rights of any third party, including without limitation any persons appearing in the film footage, video footage, and/or still photograph(s).
  • Further, I grant the Population Reference Bureau unconditional rights to use this film footage, video footage, and/or still photograph(s), in whole or part, for non-profit educational, editorial, or other non- commercial use, without requiring the Population Reference Bureau to notify me, seek my permission, or owe any form of compensation.
  • I understand that this film footage, video footage, and/or still photograph(s) will be used in an appropriate and respectful manner and I confirm that PRB is using them with my knowledge and consent.


I have read and accept these terms and conditions.




Please note: We accept mp4, wmv, wav, and avi with a file size under 1GB.