Media Cover Release Form

MEDIA COVER RELEASE FORM

Production and Contact Information

Date of Recording:     Location of Recording:

Parties

WHEREAS

WHEREAS, Producer desires to photograph, record, film and otherwise capture the image, voice, performance and likeness of Releasor in connection with the Production identified above; and

WHEREAS, Releasor is willing to grant Producer the rights described in this Release in consideration of the compensation and other terms set forth herein; and

WHEREAS, the parties intend by this instrument to set forth their entire agreement concerning the use, ownership and protection of media assets containing Releasor's likeness and performance.

Grant of Rights

Releasor hereby irrevocably grants and assigns to Producer, its successors, licensees and assigns, the exclusive worldwide right and license to record, edit, reproduce, publish, distribute, display, broadcast, sublicense and otherwise use Releasor's name, voice, performance, image, portrait, photograph, video and other media (collectively "Media") in connection with the Production and any derivative works, promotional materials, advertising, social media, commercial exploitation and any other media or formats now known or hereafter devised, in perpetuity and without further consideration except as expressly set forth in Payment Terms below.

Scope of Work

Media Types and Permitted Uses

Photo   Video   Audio   Digital Assets   Live/Recorded Broadcast   Other:

Permitted Uses (check all that apply):   Promotion   Advertising   Editorial   Social Media   Commercial   Internal Use

Payment Terms

All payments are subject to provision of an invoice and are due in accordance with the payment schedule. Producer's failure to make timely payment shall entitle Releasor to suspend further performance after providing written notice and a reasonable cure period not less than the notice period set forth in Term and Termination.

Term and Termination

Term Start Date:     Term End Date (if any):

Either party may terminate this Release for material breach by the other party if such breach is not cured within the notice period specified above following written notice. Termination shall not affect Producer's rights in Media captured prior to termination except as expressly provided in a written termination agreement signed by both parties.

Confidentiality

The parties acknowledge that certain raw footage, unreleased materials, production plans and proprietary processes may be designated as Confidential Information. Producer agrees to treat designated Confidential Information with reasonable care and not disclose such information except to employees, contractors and licensees who have a need to know and who are bound by confidentiality obligations no less protective than those in this Agreement. The confidentiality obligations shall remain in effect for years from the date of disclosure.

Representations, Warranties and Indemnification

Releasor represents and warrants that Releasor has full right, power and authority to enter into this Release and to grant the rights conveyed herein, that use of the Media as permitted will not violate the rights of any third party, and that no further consents are required. Releasor shall indemnify, defend and hold harmless Producer from and against any and all claims, liabilities, losses, damages, costs and expenses (including reasonable attorneys' fees) arising out of any breach of these representations and warranties.

Release and Waiver

Releasor hereby releases and discharges Producer, its agents, employees, licensees and assigns from any and all claims, demands, liabilities, actions and causes of action whatsoever arising out of or in connection with the use of the Media, including without limitation claims for invasion of privacy, defamation, right of publicity or other personal rights, except to the extent caused by Producer's gross negligence or willful misconduct.

Consent for Minors

If the Releasor is under the age of majority in the Releasor's state of residence, the signature of a parent or legal guardian is required below. Indicate if subject is a minor:   Yes

By signing below, parent or guardian represents that they are the legal guardian of the minor and have the authority to enter into this Release on the minor's behalf.

Governing Law; Entire Agreement

This Release shall be governed by and construed in accordance with the laws of the state of , without regard to its conflicts of laws principles. This Release, together with any attached exhibits or schedules, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings and negotiations, whether oral or written. No amendment or waiver shall be effective unless in writing and signed by both parties.

Miscellaneous Provisions

If any provision of this Release is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect. The rights and obligations under this Release are assignable by Producer, and Producer may sublicense its rights in whole or in part. The headings in this Release are for convenience only and shall not affect its interpretation.

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