Media Appearance Release Form

MEDIA APPEARANCE RELEASE FORM

This Media Appearance Release Agreement (the "Agreement") is made on by and between Participant Name: and Media Company Name: .

RECITALS

WHEREAS, Participant is willing to appear and be recorded on audio, video, photographic, digital and/or other media in connection with a media production described below; and

WHEREAS, Media Company desires to obtain the unrestricted right to use Participant's appearance, voice, likeness, performance, statements and biographical information in connection with such production; and

WHEREAS, the parties desire to set forth the terms under which such appearance shall be recorded and the rights to be granted.

NOW, THEREFORE, in consideration of the mutual covenants and other valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. DESCRIPTION OF APPEARANCE

Date of Appearance: Location:

2. GRANT OF RIGHTS

Participant hereby grants to Media Company, its affiliates, licensees and assigns, an exclusive, non-revocable, royalty-free, worldwide right and license to record, reproduce, copy, distribute, publish, display, broadcast, edit, adapt, translate and otherwise use Participant's name, likeness, image, voice, performance, statements and biographical information (collectively, the "Materials") in any and all media now known or hereafter devised, in perpetuity, for any purpose including advertising, promotion, publicity and commercial exploitation.

3. CONSENT TO EDITING; NO OBLIGATION TO USE

Participant acknowledges and agrees that Media Company shall have the unrestricted right to edit, alter, mix, dub or otherwise change the Materials. Media Company has no obligation to use or exploit the Materials and may do so in whole or in part.

4. COMPENSATION

Participant shall receive the following compensation (select one):

5. REPRESENTATIONS AND WARRANTIES

Participant represents and warrants that Participant is at least 18 years of age (or has provided the required parental/guardian consent), has full right and authority to enter into this Agreement, that the Materials provided will not infringe the rights of any third party, and that Participant has not granted any rights that would conflict with the rights granted to Media Company hereunder.

6. RELEASE and WAIVER

Participant hereby waives, releases and forever discharges Media Company, its officers, directors, employees, licensees, successors and assigns from any and all claims, demands, liabilities, causes of action, suits, damages or expenses (including attorneys' fees) arising out of or in connection with the use of the Materials, including without limitation claims for invasion of privacy, publicity, defamation, emotional distress or infringement of moral rights.

7. INDEMNIFICATION

Participant shall indemnify, defend and hold harmless Media Company from and against any and all third-party claims, liabilities, losses, costs and expenses (including reasonable attorneys' fees) arising from a breach of Participant's representations, warranties or obligations under this Agreement.

8. CONFIDENTIALITY

Unless otherwise agreed in writing, Participant understands that the Materials and any information provided in connection with the production may be retained by Media Company and used consistent with the rights granted herein. Participant shall not disclose to third parties any confidential production details designated in writing as confidential by Media Company.

9. TERM

The rights granted hereunder are perpetual unless otherwise agreed in writing. Optional expiration date:

10. NOTICES

All notices under this Agreement must be sent in writing to the contact addresses provided below and shall be deemed given when delivered personally or sent by certified mail, return receipt requested.

11. AMENDMENTS; WAIVER; COUNTERPARTS

This Agreement may be amended only by a writing signed by both parties. No waiver of any provision shall be effective unless in writing signed by the party to be charged. This Agreement may be executed in counterparts, each of which shall be deemed an original and together shall constitute one instrument.

12. GOVERNING LAW; SEVERABILITY; ENTIRE AGREEMENT

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to its conflict of laws rules. If any provision of this Agreement is held invalid or unenforceable, the remainder shall continue in full force and effect. This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings, whether written or oral.

13. ADDITIONAL PROVISIONS

Sign Now