Night to Shine Parent / Caregiver and Volunteer Media Rights Release Form
(Required for ALL Guests and Volunteers)
By signing below, and for the good and valuable consideration of participating in an event hosted by OUR LADY OF PEACE, and sponsored in part by or associated with the Tim Tebow Foundation, I hereby give my full consent to Tim Tebow Foundation, Inc., (“TTF”) a Georgia nonprofit corporation headquartered in Florida and OUR LADY OF PEACE CHURCH (“CHURCH”), two Pennsylvania nonprofit corporations, to record, by writing, by video, photographic, or audio recording device, or by any other analog or digital means, my actions, physical likeness, biographical information, and/or voice. Additionally, I hereby grant to TTF and CHURCH, without royalty or other compensation now or in the future, all rights of every kind and character whatsoever, in perpetuity, in and to any and all such recordings, along with any additional recordings I might provide to TTF and CHURCH, and to any benefits inuring to TTF and CHURCH as a result of its use of any of the foregoing recordings. Among other things, TTF and CHURCH may, but are not required to, copy or reproduce the recording, edit or modify it, incorporate it into another work, display or broadcast it or any of the foregoing privately or publicly, and use or license it or any of the foregoing for use by others, all for the sole benefit and at the sole discretion of TTF and CHURCH, for the advancement of TTF and CHURCH exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and CHURCH and bind me and my heirs, successors, and assigns. I, hereby release and discharge and agree to hold harmless TTF and CHURCH, its directors, officers, employees, volunteers, and independent contractors, from any and all claims or damages, including but not limited to defamation or violation of rights of privacy or publicity, arising from or associated with the recordings or use of recordings. This release shall be construed, interpreted and governed in accordance with the laws of the State of Florida, and should any provision of this release be determined invalid, such invalidity does not affect any of the remaining provisions. I am of full age and have the right to contract in my own name.
PLEASE NOTE: GUESTS NEED TO COMPLETE LINES 1, 2, 3 AND 4. VOLUNTEERS NEED TO COMPLETE LINES 1, 3, 4 AND 5 IF THE VOLUNTEER IS UNDER THE AGE OF 18.
1. Name of Guest or Volunteer Attending Night to Shine
*
First Name
Last Name
2. Parent / Caregiver of Guest
First Name
Last Name
3. Guest or Volunteer Date of Birth
*
-
Month
-
Day
Year
Date
4. Parent / Caregiver or Volunteer Signature
*
5. *If under 18 years of age* Parent / Guardian Signature
Date Signed
-
Month
-
Day
Year
Date
Submit
Should be Empty: