Media Image Release Consent

MEDIA IMAGE RELEASE CONSENT

This Media Image Release Consent (the "Agreement") is made effective as of by and between Releasor Name: (referred to herein as "Releasor") and Releasee Name: (referred to herein as "Releasee").

RECITALS

WHEREAS, Releasee wishes to photograph, film, record or otherwise capture the visual and/or audio likeness of Releasor in connection with the project, event, or activity described as: ;

WHEREAS, Releasor is willing to grant Releasee certain rights in the images, video and audio recordings identified below (collectively, the "Images") in accordance with the terms and conditions set forth in this Agreement; and

WHEREAS, the parties desire to set forth their respective rights and obligations with respect to the capture, use and exploitation of such Images.

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

1. GRANT OF RIGHTS

Releasor hereby irrevocably grants and assigns to Releasee and its successors, licensees and assigns a worldwide, perpetual, royalty-free, transferable and sublicensable right and license to photograph, film, record, reproduce, publish, distribute, display, modify, create derivative works from, and otherwise use the Images and Releasor's name, voice, signature, likeness, biographical information and other identifying information (collectively, the "Materials") in all media now known or hereafter devised for any purpose, including but not limited to advertising, promotion, publicity, trade, editorial, educational and commercial exploitation.

2. SCOPE OF MATERIALS

Types of capture (select all that apply): Photographs Video Audio Other

3. PERMITTED USES

The Materials may be used by Releasee for any lawful purpose, including but not limited to advertising, marketing, social media, broadcast, web distribution, internal training, documentary, archival and promotional materials. Releasor agrees that Releasee may crop, edit, combine, or alter the Materials as Releasee determines in its sole discretion.

Specific restrictions on use (if any):

4. CONSIDERATION

In consideration for the rights granted herein, Releasor acknowledges receipt of:

5. REPRESENTATIONS AND WARRANTIES

Releasor represents and warrants that Releasor is the sole owner of all right, title and interest in and to the rights granted herein, has full authority to enter into this Agreement, and that the exercise of the rights granted will not violate the rights of any third party. Releasor further warrants that the Materials do not infringe any third-party rights.

Releasor Date of Birth (if requested for verification):

6. MINOR SUBJECTS

If the subject of the Materials is under the age of 18, the parent or legal guardian must complete the following and represent that they have full authority to grant the rights herein on behalf of the minor.

7. RELEASE, WAIVER AND INDEMNITY

Releasor hereby releases and forever discharges Releasee and its officers, directors, employees, agents, licensees, successors and assigns from any and all claims, demands, actions, causes of action, suits, liabilities, damages, costs and expenses of any kind or nature arising out of or relating to the creation, editing, use, distribution or exploitation of the Materials, including without limitation any claims for defamation, invasion of privacy, right of publicity or infringement of moral rights. Releasor agrees to indemnify, defend and hold harmless Releasee from and against any losses, damages, liabilities, costs and expenses (including reasonable attorneys' fees) arising out of any breach of Releasor's representations or warranties herein.

8. MORAL RIGHTS; WAIVER

To the fullest extent permitted by applicable law, Releasor hereby irrevocably waives and agrees not to assert any moral rights or similar rights with respect to the Materials. Releasor consents to any attribution or omission of attribution in Releasee's sole discretion.

9. TERM; TERRITORY

The rights granted in this Agreement are perpetual and worldwide unless otherwise expressly limited in writing in the field below.

10. NO OBLIGATION TO USE

Releasee shall have no obligation to use the Materials or to exercise any of the rights granted herein. Any decision by Releasee to use or not use the Materials shall be within Releasee's sole discretion.

11. NOTICES

All notices required or permitted under this Agreement shall be in writing and delivered to the addresses set forth below.

12. GOVERNING LAW; VENUE

This Agreement shall be governed by and construed in accordance with the laws of the state or jurisdiction entered below, without regard to conflict of law principles. Any dispute arising out of or relating to this Agreement shall be brought exclusively in the state or federal courts located in the seat of government within the chosen jurisdiction.

13. ENTIRE AGREEMENT; SEVERABILITY

This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations and understandings. If any provision of this Agreement is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

14. AMENDMENT; WAIVER; COUNTERPARTS

No amendment or modification of this Agreement shall be effective unless in writing and signed by both parties. No failure or delay in exercising any right shall operate as a waiver. This Agreement may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one instrument.

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