AUDIO AND VIDUAL RELEASE AND WAIVER
Consent. By signing this form, I acknowledge, understand, and release that:
1. The above named party hereby consents to the use by the Company, its authorized
representatives, assignees, subsidiaries and licensees of his/her name, photo, likeness,
image , handwriting, testimonial, video and/or sound recording in any media now
known or hereafter devised (collectively referred to herein as “Information”), and to
allow the Company to record, reproduce, used exhibit, broadcast, and publish derivative
works of the above named party, to promote or publicize the Company’s businesses.
2. The above named party also hereby grants a perpetual, worldwide and irrevocable
license to the Company to use the Information in any manner or media, including, but
not limited to, reproduction, sale, exhibition, copying, broadcast, and distribution of the
3. The above named party has read this Release and Waiver, and understand its contents
and intend to be legally bound hereby, for good and valuable consideration, receipt of
which is hereby acknowledged.
4. The above named party forever releases and agrees to hold harmless the Company from and against any and all claims arising from the use of such images and information.
5. If any provision of this Agreement, or any portion of it, is held to be invalid and
unenforceable, then the remainder of this Agreement will nevertheless remain in full
force and effect.