toastmasters photo video release form pdf

Media Consent and Release Agreement

Instructions for Use

• Complete all bracketed fields accurately before presenting this form to the participant or their legal guardian.
• Ensure the participant initials the specific usage clauses to confirm informed consent for both digital and print media.
• Maintain the signed original in a secure, digital, or physical filing system for the duration of the media's lifecycle or as required by your organization’s document retention policy.

Parties and Definitions

This Media Consent and Release Agreement ("Agreement") is entered into by and between [Organization Name] ("Organization") and the undersigned individual ("Participant").

Participant Name: [] Date of Event/Recording: [] Description of Event/Project: [__________]

Operative Clauses

1. Grant of Rights: Participant hereby grants to Organization, and its successors and assigns, the irrevocable, perpetual, worldwide right and license to use, reproduce, edit, exhibit, project, display, copyright, publish, and distribute the Participant’s name, voice, likeness, image, and performance (collectively, "Media") in any and all media now known or hereafter developed, including but not limited to social media, websites, promotional materials, and internal training documents.

2. Waiver of Compensation: Participant acknowledges and agrees that they shall receive no financial compensation, royalties, or other consideration for the use of the Media as described herein.

3. Release and Indemnification: Participant hereby releases, discharges, and holds harmless Organization and its officers, directors, employees, and agents from any and all claims, demands, or causes of action arising out of or in connection with the use of the Media, including but not limited to claims for defamation, libel, invasion of privacy, or right of publicity.

4. Usage Preferences: Participant indicates their consent preference for the following:

   • All media usage (Public and Internal)
   • Internal/Educational use only (Not for public social media)
   • Print media only (No digital/web distribution)

5. Representations: Participant represents that they are at least 18 years of age (or that a parent/legal guardian is signing on their behalf) and have the full right and authority to enter into this Agreement.

Signature and Acknowledgment

By signing below, I acknowledge that I have read this document, understand its contents, and voluntarily agree to its terms.

Signature: __________ Printed Name: [] Title/Role: [] Date: [__________]

Legal Disclaimer: This document is a general framework intended for informational purposes only. It does not constitute legal advice. Please consult with qualified legal counsel to ensure this document complies with the specific laws and regulations of your jurisdiction.