Please duplicate and
submit “Release and Agreement Form”
For video contest participants only.
RELEASE AND AGREEMENT – NO
MONETARY COMPENSATION
I authorize PRIIME TIIME TODAY
to make use of my name, likeness, voice performance and property in the program/series: _____________________________________________________________________________
and for further purpose of publicizing and promoting the production.
I further authorize PRIIME
TIIME TODAY to edit the production in whole or in part, for radio and television
broadcasting, cable casting, audio/visual, closed circuit exhibition, Internet,
and all other electronic and mechanical distribution throughout the world
in perpetuity. PRIIME TIIME TODAY shall have complete ownership of the production,
including full domestic and foreign copyright, and shall have the exclusive
right and license to make such use of the production as it wishes, including
(but not limited to) the right of performance, display and reproduction and
the right to create, perform, display and distribute derivative works
of the production. The right
to use the recordings is understood to include the right to make alterations
or additions to the recordings and to register the copyright(s) for the recordings.
I also understand that PRIIME TIIME TODAY has no obligations to use the recordings.
My work in the production shall
be a work made for hire under copyright laws of the United States, to the
extent that my work cannot be considered a work made for hire, I assign all
rights and title, including all copyright rights in the production and its
derivative works, to PRIIME TIIME TODAY.
If by reason of my statements
and actions in the production or by reason of property (ies) or materials(s)
furnished by me for the production, there is any claim or litigation involving
any charge by a third party of violation of his/her rights, I agree to hold
PRIIME TIIME TODAY harmless from liability, loss of expense arising from such
claims of litigation.
I further agree that my appearance
or participation in the production constitutes consideration for this release.
I also agree that I am to receive
no monetary consideration for my appearance or participation in the production,
and will receive no compensation from the broadcast or other electronic or
mechanical distribution or sale of the production.
I represent that I am 18 years
of age and have the right to enter this agreement or if under 18 years of
age, my parent or guardian has executed this release on my behalf.
I'm entering the Signposts Media Literacy Contest for 2008:
"How Can I Be An Independent Thinker In An Internet Dependent World?"
DATE ___________________SIGNATURE
________________________________________
NAME _____________________________________________________________________
ADDRESS ________________________City_________________,
STATE__, ZIP _________
PARENT/GUARDIAN SIGNATURE IF
UNDER 18 YEARS OF AGE
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