WAIVER AND RELEASE AGREEMENT
PHOTO OR VIDEO SUBMISSION CONTEST
**This form must be filled out completely, signed, and both pages faxed to 312-329-9682 or
scanned and e-mailed to email@example.com
before photos/videos can be posted on https://www.facebook.com/1075wgcifm**
I ________________________ am participating in a promotional contest called ______________________ (herein defined as the “Contest”) conducted by radio station _______________________ (herein defined as the “Station”). In order to participate in the Contest, I have personally submitted a photograph or video or recording (herein defined as “Media’) which may be posted on the Station’s internet website for voting. By participating in the Contest, I have a chance to win ____________________________________________________(the “Prize”). I understand that the Media submitted may be viewed on a public website and may be judged or voted on by the public as a part of the Contest. I understand that in order to participate in the Contest, I also consent to be subject to the station’s Contest rules and have reviewed the Contest Rules. In consideration for allowing me to participate in the Contest, I understand and agree to the following:
For purposes of this Release Agreement, the “Released Parties” shall mean any person or entity associated in any way with the Contest, including but not limited to the Station, Contest sponsors, Clear Channel Broadcasting, Inc., and each of their respective parent, subsidiaries, affiliates, officers, directors and employees. Furthermore, for purposes of this Release Agreement, the term “Loss” shall mean all damages, losses, costs, and injuries of every kind and character including, but not limited to, all economic damages, loss of business opportunities, embarrassment, mental anguish, loss of consortium, loss of services, loss of companionship, and loss of employment.
IN CONSIDERATION FOR ALLOWING Me TO PARTICIPATE IN THE CONTEST, I, hereby hold harmless, release, indemnify, and discharge from liability THE RELEASED PARTIES from all liability, claims, judgments, demands, controversies, agreements, damages, actions, and causes of action whatsoever, ARISING OUT OF OR RELATED IN ANY WAY TO THE CONTEST OR the conduct of the contest, WHETHER in law or equity, no matter what the cause OR NATURE, AND I FURTHER WAIVE ANY CLAIMS THAT I MAY STATE OR ASSERT AGAINST ANY OF THE RELEASED PARTIES IN association with the CONTEST or any of its associated activities, or in any way related to or resulting from the CONTEST EVEN IF SUCH INJURY OR CLAIMS RESULTS from or IS caused by THE negligence or gross negligence OF ANY OF THE RELEASED PARTIES, in whole or in part. I further agree to indemnify and hold harmless THE RELEASED PARTIES from any claim arising out of my participation in the CONTEST including, without limitation, all claims brought or asserted by any third party as a result of any INJURY OR LOSS THAT I OR THEY MAY sustain IN ANY WAY ASSOCIATED WITH MY PARTICIPATION.
I hereby warrant and represent that (i) I am the sole owner of the Media submitted in the Contest; (ii) that I have obtained the written consent, release, and/or permission of each and every identifiable individual person in the Media submitted to use the name or likeness of each and every such identifiable individual person to enable inclusion and use of the Media in the manner contemplated by the terms of the corresponding Contest Rules. (iii) if representing that the Media subject is myself, by my signature and submission of this release, I warrant that the subject of the Media is myself and of no one else; (iv) that such Media does contain any materials owned or controlled by a third party for which I have not obtained a license; and (v) that such media does not infringe on any third party’s intellectual property rights, including copyrights, trademarks, rights of privacy, publicity or other intellectual property or other rights of any person or entity.
I understand that by entering and submitting in the Contest, I have granted to the Released Parties, a perpetual, worldwide, non-exclusive, royalty-free, sub-licensable (through multiple tiers) right and license to use, publish, reproduce, display, perform, adapt, modify, distribute, have distributed and promote such content in any form, in all media forms, now known or hereinafter created, anywhere in the world, for any purpose.
I acknowledge and agree that the Released Parties may subsequently use for publicity and/or promotional purposes, my name, likeness, photographs, videotapes, other recordings or Media, including but not limited to the Media submitted in the Contest, without any additional consideration to me beyond allowing participation in the Contest.
I understand and agree that the Media posted on the Station’s website, may be posted for the purposes of a website based voting competition alongside other contestants. The competition may be advertised by the Station on-air or by other advertising medium.
I certify, acknowledge and agree as follows: (i) I am over the age of eighteen (18) and am legally competent to sign this Release; (ii) I have read this agreement carefully and understand its provisions; (iii) I understand that I have the right to consult with an attorney; (iv) I have determined that it is in my best interest to enter into this agreement; (v) I have not been influenced to sign this agreement by any statement or representation by the Released Parties not contained herein; (vi) If any provision of this Agreement is deemed unenforceable or void, the remainder of this Agreement shall not be affected and will be fully enforceable, and (vii) I enter into this agreement knowingly and voluntarily.
Print Name: ___________________________________
MINOR’S RELEASE STATEMENT (IF MEDIA SUBJECT IS UNDER 18 YEARS OLD, PARENT OR LEGAL GUARDIAN MUST REVIEW AND SIGN MINOR’S RELEASE BELOW:
I hereby confirm and certify that I am the parent or legal guardian of __________________________ ___________________________________ , “My Minor Child(ren)”. I hereby execute the foregoing Waiver and Release for and on behalf of My Minor Child(ren) and agree to bind myself, My Minor Child(ren)’s and any heirs, next of kin assigns or personal representatives to all the terms of this Waiver and Release. I fully consent to My Minor Child(ren)’s participation in the Contest and I agree that all provisions of the above Waiver and Release shall be effective as to My Minor Child(ren). I also agree to indemnify and hold harmless the Released Parties for any expenses, claims or liabilities that may arise as a result of any insufficiency of my full legal authority to execute the foregoing Waiver and Release Agreement.
Parent/ Legal Guardian Signature: Date: _________________________
Parent/ Legal Guardian Printed Name: _________________
Minor Child Name: _________________________________________________________________________
Minor Child Name: __________________________________________________________________________
Address: City/State/Zip: ____
*THIS FORM MUST BE FILLED OUT AND SIGNED BY THE LEGAL GUARDIAN OF A MINOR CHILD