Photo/Video Authorization Release Form

The Substance Abuse and Mental Health Services Administration (SAMHSA)/Center for Substance Abuse Prevention (CSAP) is preparing an archive of the 2010 national THMs on underage drinking prevention. You may have already developed an authorization release form for photos and videos to distribute at your event and obtain participants’ permission to be photographed or videotaped. To assist your agency as well as SAMHSA/CSAP, please complete and return this form (PDF 26 KB) so that SAMHSA/CSAP has your permission to use your clippings. Please send this form along with your newspaper articles, press releases, proclamations, photos, and videos from your event by email to info@stopalcoholabuse.net or send copies by regular mail to:

Attn: Town Hall Meeting Clippings
11420 Rockville Pike
Rockville, MD 20852

Links and text posted on your blogs, Facebook and Twitter pages, or other social media sites will also be accepted. Your submission of materials to SAMHSA/CSAP’s archive will greatly enhance the historical value of what has been accomplished across the Nation. SAMHSA/CSAP greatly appreciates your participation and support of the 2010 THMs.

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