Release Form without Signature

I made tapes, photographs, other recordings, transcriptions and/or other
documentation of

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(Informant -- please print name)
in conjunction with my folklore collection project,

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(Item or collection number[s])

Although the interviewee named above did not sign a consent form, we talked about
placing the materials in the Jack Horntip Collection where they will be available to
the public. We also talked about allowing the interviewee's words to be quoted, music
or recordings played and pictures to be shown in a publication or exhibition. The
interviewee consented to these actions except for any restrictions that may be listed
below. I explained that by giving this permission the interviewee has not limited any
copyright or performance rights that he or she may hold, and that collectors and
informants retain the right of free access to the collection through normal procedures
of the Collection and its personnel.

      (     ) No further restrictions     (     ) See below for further restrictions:

(If none are listed, it is assumed there are no restrictions.)

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Signed: _______________________________ Date: _________________