U.S. Fish & Wildlife Service
Agreement for Use of Images and
Likenesses in Service Products
Instructions
A signed release is required from Non-Service subjects appearing and requiring identification in all photographs and videos
taken by Federal Employees or their agents. In the case of minors, the parent or guardian must sign the release. Completed
forms are maintained at the originating office and copies are sent to the Regional External Affairs Office prior to use in any
Service Product.
Photographer/Videographer:
Office and Phone:
Photograph and Video Copyright Release
I hereby grant permission to the U.S. Fish and Wildlife Service (“Service”) to make visual and/or audio recordings and still
images of myself and/or any minor under my control at the time of the recording. I also grant permission to the Service to
use my photographic, video graphic, and/or audio image and/or likeness and/or any minor’s photographic, video graphic,
and/or audio image and/or likeness, who is under my control at the time of the recording, in official Service publications,
displays, on the Internet and its World Wide Web Site without any consideration. These images are for public domain use
unless specific restrictions are noted below. I also understand that a computer user in or out of the Service can download the
images, photographs, video recordings, and/or audio recordings. The image will be credited to the U.S. Fish and Wildlife
Service unless otherwise noted below.
Therefore, I agree to indemnify and hold harmless from any claims the following:
• U.S. Fish and Wildlife Service
• U.S. Department of the Interior
• All employees or agents of the Department of the Interior
I agree to the above full copyright release:_ (Signature)
or
Special Agreement Instructions (purchase information, usage restrictions, etc.):
Product Description (image number, subject, horizontal/vertical, location, title, etc.):
Name: (Adult or Guardian)
Name: (Minor)
Address:
Phone:
Signature: Date:
