Fillable Printable General Interview Release Form

General Interview Release Form

Interview Release Form

I understand that (the Author) is preparing and writing a work (the Work), tentatively titled , which

will be published by the University of Michigan Press (the Press), a non-profit organization.

In order to assist the Author and the Press in the preparation of the Work, I have agreed (a) to be

interviewed, (b) to the recording of this interview in any form and in any media, and (c) to provide

information and other materials to be used in connection with the Work, including my personal

experiences, remarks, incidents, dialogues, actions, and recollections, as well as any photographs and

documents that I may give to the Author or the Press (collectively, the Interview Materials).

I hereby grant to the Author and the Press, and to the licensees, successors, and assigns of each:

1. The right to quote, paraphrase, reproduce, publish, distribute, or otherwise use all or any portion of the

Interview Materials in the Work, and in advertising and related promotion of the Work, in all forms and in

all media throughout the world and in perpetuity.

2. The right to use my name, image, and biographical data in connection with any use of the Interview

Materials, including as described above.

I hereby waive any right I may have to inspect or approve the use of my name, image, biographical data,

or Interview Materials as incorporated in the Work, and acknowledge that I have no copyright or other

rights in the Work.

I hereby release and discharge the Press, the Author, and the licensees, successors, and assigns of each,

from any and all claims, demands, or causes of action that I may have against them regarding any use of

the Interview Materials or regarding anything contained in the Work or in related advertising or

promotional materials, including (but not limited to) any claims based on the right to privacy, the right to

publicity, copyright, libel, defamation, or any other right.

Agreed and confirmed:

Signature: ________________ Date: ________________

Name (print): ________________