Media Release Form

Use the guidelines below to know when the Early Childhood Learning and Knowledge Center (ECLKC) Media Release Form is required.

When to Use the Form

Media Release Forms are required for all:

  • Audio and video media: If the video includes individuals other than presenters, unless you are using stock video footage.
  • Still and video photos
  • Copyrighted material
  • Presentations by individuals who are not full-time federal staff

When submitting video recordings, a still photo from the actual video shoot is required for each subject and speaker displayed. Place each still photo in its corresponding media release form. Illustrations originally used or found in another government resource may be used freely as long as the agency is credited.

Individual Media Release Form

Download the Media Release Form: English and Spanish.

Blanket Media Release Form for Organizations

The form gives permission to the U.S. Department of Health and Human Services, Administration for Children and Families for the use of names, photograph, video, likeness, artwork, profile, and/or story in all forms of media and all manners, including publications, webpages, video, and other promotional materials. The form is customized for National Center use, but it can be modified for grant recipients or contractors. The funding announcement/agreement or contract terms determine whether or not use of non-government employees' images and stories is permitted.

Download the Blanket Media Release Form.

Microsoft Media Elements

While no fee is charged to use any forms of Microsoft Media Elements, even if modified, Microsoft does require that it be identified as the copyright holder for each media element used.