I,   First Name*   Last Name*   ("Contributor") provide Parole Justice Works ("PJW") with a video recording called    Video file name (example: "Heidi.mov")*  
("Video") for use on its website, www.parolejustice.org  ("Website").  
I authorize PJW the right and permission to publish, reproduce, or otherwise use the Video on the Website.  I understand the Website is public, that any member of the public can access videos on the Website through the internet, and that PJW cannot control what people who access the Website do with its content. I grant PJW full
discretion as to where to put the Video on the Website and how to display it.
I understand I can request for PJW to remove the Video from the Website and/or to delete the Video from its records. I understand I must make this request in writing by emailing info@parolejustice.org, clearly stating my name and request. Unless I request the removal or deletion of the Video, there is no time limit on the validity of this release.
I acknowledge and grant PJW and its employees, agents, licenses, successors, and third-party organizations all ownership rights and irrevocable right and permission to publish, reproduce, or otherwise use the Video on the Website.
I take full responsibility for my involvement in this project and the risks that it may entail (be they legal, physical, mental, etc.) and release PJW from any claims, demands, losses, damages, suits, and liabilities of any kind whatsoever in connection with the foregoing.
I certify that I am the person in the Video, that anyone appearing in the video knowingly consented to its recording, knowingly consents to it appearing on the Website, and has completed this release themselves.
I certify that I am over 18 years of age and am competent to contract in my own name insofar as the above is concerned. If I am under 18 years of age, my parents or legal guardians have read this document and have given their consent by signing below.