Hey Trauma, The Day We Me Campaign.

RELEASE, TO HOLD HARMLESS AND AUTHORIZATION TO REPRODUCE VOICE, PHYSICAL LIKENESS, AND INTERVIEW

This is a Consent, Release of Rights, Hold Harmless and Authorization Agreement between Dr. Tama Lane for the purpose of the Hey Trauma the Day We Met Campaign (defined bellow and referred to as, Hey Trauma, The Day We Met), its officers, directors, employees and Designees of each of same (collectively, “”), and Participant (defined below and referred to as “I”, “Me”, “My” and “Participant”). “Designees” includes those persons or entities managing, contracting, sponsoring, hosting, conducting, evaluating or publicizing (including individuals and entities working with Hey Trauma, The Day We Met campaign in print, publication, television, broadcast or video media). As used in this Agreement, “Participant” shall mean any individual, mentor, teacher, volunteer, Artist, collaborator or other person or entity involved in a Hey Trauma The Day We Met campaign listed above.

In consideration of My participation in one or more of Hey Trauma The, Day We Met campaign, I agree to the following:  I hereby grant Dr Tama Lane for the purpose of Hey Trauma, The Day We Met campaign the right to written work(s), interviews and recordings, to produce and publish such recordings, in whole or in part, to photograph me or otherwise record my image, both in still and motion pictures, and record my voice, separately and in synchronization with each other, by any means now known or hereafter  to be discovered, together with the non-exclusive but perpetual right to use and duplicate such written work,  photographs or other images of me, whether in print, social media, negatives, slides, videotape, or otherwise digitally record, film sequences or other formats, and reproduce my voice, separately or in synchronization with such images, or collect my name, biography, plus any other information I provide, associated with my attendance at and/or participation in any Hey Trauma, The Day We Met campaign.  I further acknowledge that any works made by or for Hey Trauma, The Day We Met campaign (“Works”) to be “works made for hire,” under applicable copyright laws, and to the extent I have or may claim any rights in or to such Works, I hereby grant Hey Trauma The Day We Met campaign any and all such rights, including, without limitation, the right to use or sublicense these Works in any and all media, now known or later discovered or developed, and in all forms and for all purposes, including without limitation, advertising and all types of promotions for Hey Trauma The Day We Met events and projects, without any further consideration due to Me or any limitation whatsoever.

I hereby waive the opportunity or rights to inspect or approve any such copy, text, proof, negatives, tests, finished films, videotapes, audiotapes, digital images or recordings, and photographs or the uses to which the same may be put. All copies of my image, likeness and voice created or recorded by you or your designee hereunder shall be your sole and exclusive property, including any and all prints and negatives depicting the same. I hereby acknowledge that the copyright to any performance by me recorded by you or your designee hereunder shall be owned exclusively by you for the term of such copyright, all such rights in and to said performances have been transferred by me to you herby.   

I recognize that there may be risks associated with attending and/or participating in a Hey Trauma, The Day We Met campaign, including, without limitation, risks inherent in the construction and/or operation of working in unpredictable conditions, as well as in working near electrical connections, traveling to and from events, and participating in public works/performances, being exposed to all weather conditions. These risks include the risk of injury (including without limitation, serious bodily harm and even death) and property damage, Psychological and emotional distress due to the nature and mature subject matter.  Being fully cognizant of the risks in participating in any such event, I hereby fully and willingly assume those risks. I HEREBY WAIVE ANY CLAIMS OR CAUSES OF ACTION which I may now have or hereafter arises against Hey Trauma The Day We Met campaign arising out of or connected to My participation in any Hey Trauma The Day We Met event or project and I will indemnify and hold harmless Hey Trauma The Day We Met campaign against any and all claims against any such entity or person resulting from same.  I HEREBY RELEASE Hey Trauma The Day We Met and each of their respective successors, assigns, affiliates, licensees and agents from any and all claims, demands, liabilities, damages, costs and expenses, attorneys’ fees, other professional fees and expenses, including, without limitation, any claims for compensation, defamation, or invasion of privacy, or other infringements or violations of personal or property rights of any sort whatsoever that I may now or hereafter arise against Hey Trauma The Day We Met campaign arising in connection with my participation in any Hey Trauma, The Day We Met event and project.  In the event I should sustain any injuries or illness while participating in a Hey Trauma The Day We Met event or project, I hereby authorize Hey Trauma The Day We Met to administer, or cause to be administered, such first aid as reasonably suggested under the circumstances, including, without limitation, treatment by a physician or hospital of Hey Trauma The Day We Met campaign. In providing my cell phone number below I authorize Hey Trauma, The Day We Met, and its agents the right to send texts for both the purposes of communicating event/project information as well as promotional information. I further understand that Hey Trauma, The Day We Met is not responsible of any charges resulting from these texts. This Release shall be binding upon My heirs, personal representatives, and Me.  THIS RELEASE SHALL BE GOVERNED BY AND CONSTRUED UNDER THE LAWS OF THE STATE OF NEW YORK, WHICH SHALL BE THE VENUE FOR ANY LEGAL ACTION.  This Agreement constitutes the entire agreement among the parties hereto with respect to the subject matter hereof and supersedes any and all previous agreements among the parties, whether written or oral, with respect to such subject matter.

  

In signing this release, I acknowledge that I have read this agreement in full, to be bound by the rules and regulations therein. I hereby warrant that I am 18 years of age or older, that I am fully competent to execute this agreement, I UNDERSTAND THAT THIS FORM INVOLVES A RELEASE OF LEGAL RIGHTS.

 

Participant Name: [Print Clearly] ____________________________

Participant Signature: ________________________________ Date: ___________

Email address: __________________________________

Cell: (        ) _________________

For Participants under the age of eighteen (18) years listed above:  I hereby consent and agree to all of the terms and conditions of this Agreement as the Parent/Legal Guardian of ____________________________________________(minor participant’s name), in which case “I”, “Me”, “My” and “Participant” as used herein shall refer to said minor.

Print Parent or Guardian Name ______________________________
Parent or Legal Guardian Signature ___________________________Date_______