CREATIVE INDUSTRIES RESEARCH CLUSTER (CIRC)

University of Brunei Darussalam

PERMISSION AND RELEASE FORM

TO BE SIGNED BY YOUR PARENT OR LEGAL GUARDIAN IF YOU ARE UNDER 18 YEARS OLD

I, ________________________________________________________, or the parent/legal guardian of ____________________________________________, a child under the age of eighteen (18), consent to the inclusion and display of  my or my child's picture and artwork as described below.

By signing this document, I acknowledge that I or my child has participated in academic research activities conducted by ________________________ ("Artist") of Visions of Brunei: A Cultural Free-to-All Visual Experience of Digital Hybrid Mural, Creative Industries Research Cluster (CIRC) of the University of Brunei Darussalam (UBD) and grant my consent to the inclusion of electronic documentation of my or my child's image, pictures taken during project activities and/or artwork as part of output images for the Visions of Brunei: A Cultural Free-to-All Visual Experience of Digital Hybrid Mural research project.

I understand and agree that electronic documentation submitted as part of the individual artist's submissions to the Visions of Brunei: A Cultural Free-to-All Visual Experience of Digital Hybrid Mural project may be utilised and displayed in the following ways:

1. Display, alteration and/or cropping in the process of creating a digital hybrid mural and related merchandises;
2. Educational research and evaluation of this research project by the CIRC of UBD; and
3. Public display via the CIRC's blog, UBD's website and any other electronic formats deemed suitable, and/or in printed materials and public places.

I consent to the use of my or my child's name and details of my or his/her image, pictures taken during project activities and production, and/or artwork itself at any stage of the production and/or merchandising process without restriction and without compensation to me.

I understand and agree that neither I nor my child will have any right of approval of or claim arising out of any electronic use of my or my child's images, pictures taken during project activities  and/or artwork by CIRC, including but not limited to claims based on defamation, right of privacy or publicity, and intellectual property. I acknowledge that CIRC will rely on this permission potentially at substantial cost to itself and hereby agree not to assert any claim of any nature whatsoever against anyone relating to the exercise of the permissions granted hereunder and not to seek any compensation for such use. CIRC may use submitted electronic documentation at its sole discretion and nothing herein shall obligate CIRC to utilise my or my child's images, pictures taken during project activities and/or artwork in any manner descibed herein.

Signature IC # (and color) Date