Company Letterhead
{{company_name}}
{{company_address}}
Phone: {{phone}}
Email: {{email}}
Website: {{website}}
1. Introduction and Purpose
This Media Release Form ('Form') is an agreement between {{company_name}} ('the Company') and the undersigned individual ('the Releasor'). By signing this Form, the Releasor grants the Company permission to use their likeness, image, voice, and/or any content provided by them for social media purposes.
The purpose of this Form is to ensure proper consent is obtained for the publication of media content featuring the Releasor on the Company's various social media platforms, including but not limited to, Facebook, Instagram, Twitter, LinkedIn, and YouTube.
2. Grant of Rights
I, {{releasor_full_name}}, hereby grant unto {{company_name}}, its agents, employees, and assigns, the irrevocable and unrestricted right and permission to use my likeness, image, voice, name, and/or any content (including photographs, videos, audio recordings, testimonials, and written statements) provided by me, in all forms and media, including reproductions, for the Company's social media platforms and promotional purposes.
This grant includes, but is not limited to, the right to photograph, videotape, or otherwise record me, and to use such recordings in whole or in part, without restriction as to alteration, distortion, or composite use, throughout the world, in perpetuity, for the Company's business and marketing purposes on social media.
3. Waiver of Rights
I waive any right to inspect or approve the finished product, including written copy, video, or audio recordings, or any other media that may be created in connection therewith. I also waive any right to royalties or other compensation arising from or related to the use of my image, voice, or content.
I understand and agree that all such media shall be the sole property of {{company_name}}.
4. Release and Indemnification
I hereby release, discharge, and agree to indemnify and hold harmless {{company_name}}, its directors, officers, employees, agents, and assigns from any and all claims, demands, or causes of action that I or my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization and release.
5. Acknowledgment of Voluntary Consent
I confirm that my participation is voluntary and that I have been given the opportunity to ask questions regarding this Media Release Form. I understand that I am not obliged to sign this Form and that my refusal to do so will not negatively impact my employment (if applicable) or relationship with the Company.
6. Governing Law
This Form shall be governed by and construed in accordance with the laws of {{country}}.
7. Releasor Details
Full Name: {{releasor_full_name}}
ID/Passport Number: {{releasor_id_number}}
Contact Number: {{releasor_contact_number}}
Email Address: {{releasor_email_address}}
Signature Block
______________________________________
Signature of Releasor
Date: {{signature_date}}
______________________________________
Printed Name of Releasor
______________________________________
Signature of Company Representative
Date: {{company_signature_date}}
______________________________________
Printed Name of Company Representative
Title: {{company_representative_title}}
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