Publicity & Liability Release Form
Meemic Insurance Company, The Meemic Foundation for the Future of Education, and The Auto Club Group and its subsidiaries and affiliates (collectively, “the Club”) use testimonials, endorsements, and media submitted by members and customers for purposes of marketing, advertising, and promotion (collectively, “Promotion”). All testimonials, endorsements, and media I submit, including but not limited to my name, photographs, likeness, image, biographical information, video recordings, audio recordings, and written statements about my experiences, beliefs, and opinions regarding the Club, their products, and services shall be deemed Testimonial Information, which may, in the Club’s sole discretion, be used for Promotion. By executing this Publicity Consent/Release, I acknowledge and affirm that the Testimonial Information I submit accurately reflects my true and actual experiences, beliefs, and opinions, and consists of my own statements that have been voluntarily provided. I further acknowledge that I have not received, nor have I been promised, compensation for the use of my testimonials, endorsements, and media. All testimonials, endorsements, and media I submit shall become the property of the Club once submitted and shall not be returned.
By executing this Publicity Consent/Release, I hereby:
1) Irrevocably grant the Club and its advertising and promotion agencies the right to use (without fee or payment, or the right to inspect or pre-approve the finished promotional product or copy that may be used) all testimonial, endorsements, and media I submit, including photographic, video, and audio media, for the Club’s Promotion projects (including permission to reproduce the Testimonial Information statements in different words that have substantially the same meaning, but edited for clarity and/or conciseness) in any published, broadcast, or electronic form (including the internet), and any other present or future medium of advertising, publicity, or trade in any part of the world for an indefinite period of time; and
2) Hold harmless, remise, acquit, satisfy, release, and forever discharge the Club and each of their respective parent companies, subsidiaries, affiliates, advertising, and promotion agencies, and each of their respective officers, directors, shareholders, agents, and employees of and from all manner of action and actions, cause and causes of action, claims, demands, damages, costs and expenses, including attorney fees, in law or in equity, which I or my successors can, shall, or may hereafter have, for use of the Testimonial Information.
I warrant that I am at least eighteen (18) years old, that I have every right to contract in my own name, and that no promise or representation that is not expressed in this Publicity Consent/Release has been made to me. I have read this document, understand it, and sign it voluntarily.