Media Release Form

{{company_name}}

{{company_address}}

Phone: {{phone}} | Email: {{email}} | Web: {{website}}

Media Release Form

Media Release Form

Grant of Rights

I, {{name_of_individual_or_entity}}, residing at {{address_of_individual_or_entity}}, hereby grant to {{company_name}}, its subsidiaries, licensees, successors, and assigns, the irrevocable right and permission to use my (or my represented entity’s) likeness, image, voice, recorded performance, and/or any provided content (photographs, videos, audio recordings, testimonials, written statements) for any purpose, including but not limited to, advertising, publicity, promotional materials, educational materials, and all other forms of media and exploitation, whether now known or hereafter devised, throughout the universe and in perpetuity. I understand that this material may be used in various formats, including print, digital, broadcast, and online platforms.

Waiver and Release

I waive any right to inspect or approve the finished product, including written copy, video, audio, or other media, wherein my likeness or content appears. I understand and agree that I will not receive any compensation for the use of my likeness, voice, or content. I hereby release, discharge, and agree to hold harmless {{company_name}} from any and all claims, demands, or causes of action that I may now have or may hereafter acquire for libel, defamation, invasion of privacy, publicity, or infringement of copyright or trademark, arising out of any use of my likeness, voice, or content.

Representations and Warranties

I represent and warrant that I am at least eighteen (18) years of age and have the full right, power, and authority to enter into this Media Release Form. If I am signing on behalf of a minor, I represent and warrant that I am the parent or legal guardian of the minor and have the full right, power, and authority to grant these permissions on their behalf. I further represent and warrant that any content provided by me is original and does not infringe upon the intellectual property rights of any third party.

Governing Law

This Media Release Form shall be governed by and construed in accordance with the laws of {{jurisdiction_country_or_province}}, without regard to its conflict of laws principles. Any disputes arising under or in connection with this Form shall be subject to the exclusive jurisdiction of the courts located in {{jurisdiction_city}}, {{jurisdiction_country_or_province}}.

Entire Agreement

This Media Release Form constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements and understandings, whether written or oral, relating to such subject matter. This Form may not be amended or modified except in writing signed by both parties.

IN WITNESS WHEREOF, I have executed this Media Release Form on the date first written above.

Signature

________________________________________

{{name_of_individual_or_entity}}

Date: {{date_signed}}

________________________________________

Signature of Parent/Legal Guardian (if applicable)

Printed Name: {{name_of_parent_or_guardian}}

Date: {{date_signed_guardian}}