Kumon Media Release Form
Dear Kumon Parent/Guardian (you may refer to you in the document as “You” or “Your”):
This General Media Release Form allows Kumon North America, Inc. ("we" or “Kumon”) to use or distribute your child(ren)’s photos, name, testimonial, student profile, quote, progress report, completed worksheets, video recording and/or likeness (the "Materials") for the stated purpose below.
You hereby irrevocably authorize Kumon to edit, alter, copy, exhibit, publish, exploit or distribute the likeness of the Materials for the purpose listed below, or for publicizing Kumon programs commercially or otherwise, training Kumon Associates or Instructors or for any other lawful purpose. Kumon reserves the exclusive right to edit the Materials, to use them in whole or in part, or not use them at all. You waive the right to inspect or approve the Materials, including written or electronic, whether that use is known to You or unknown. You also grant Kumon, and those acting under its authority, all rights, title and interest, and copyright of the Materials. Furthermore, You agree to defend and hold harmless and release and forever and discharge Kumon from all claims, demands and causes of action, which You, Your heirs, representatives, executors, administrators or any other person acting on behalf or on behalf of Your estate have or may have by reason of this Media Release Form.
I affirm that I am the parent or guardian of the child(ren) listed below and have the legal authority to sign this Form. I have read the Media Release Form beforesigning below; have signed of my own free will without duress or coercion; and fully understand the contents, meaning and impact of this document.
If you have any questions about releasing information, discuss with Kumon staff prior to signing this form.