Alliance of Health Care Unions -Release and Consent Agreement – For Photos, Audio, Name, and Creative Works Use with Alliance Union Members, Professional Models, Others:
I, the undersigned registrant in exchange for valuable consideration received, hereby irrevocably consent to the unrestricted use of Alliance of Health Care Unions “Alliance,” and Alliance union affiliates, the Kaiser Permanente Labor Management Partnership, subsidiaries, and the irrespective directors, officers, employees, agents, customers, successors and assigns (collectively “Alliance”) of the following:
- Photographs/Video Recordings: any and all photographs and/or video recordings taken of me and all images created from such recordings (collectively “Images”).
- Audio Recordings: any and all audio recordings made of my voice and all recordings created from such recordings.
- Name/Statements: my name and any stories, statements or quotes I have provided (whether quoted or paraphrased, with or without enhancements)
- My Personal Artwork, Photos or Other Creative Works: paintings, songs, stories, videos, photographs or other original, creative works (“Creative Works”) which I created and have submitted to Alliance of Health Care Unions for its use.
Scope of Consent. Alliance may use my name, images, audio recordings, statements and/or Creative Works as indicated above, for any and all purposes, including but not limited to use in promotional materials, health education materials, public relations, professional education, and art, and in all media, including electronic, digital, Internet, and print media, without further compensation to me. I certify that I am not a minor and am free and able to give such consent. (If the person is a minor, a parent or guardian must complete the relevant section below.)
Term. This consent shall become effective immediately and shall remain in effect until November 1, 2033.
The term "Consideration" means any and everything you might have received from Alliance in exchange for your participation, whether it’s a gift card or just the fun of being a part of our promotional activities.
Waiver. I waive any right to approve: 1) the finished photographs, Images, audio recordings and/or statements made by me, and any marketing materials or other printed, video or digital matter that may be used in connection with my name, images, audio recordings, statements and/or Creative Works; and 2) the eventual use of any of the foregoing. I acknowledge that Alliance owns all rights in the photographs, Images, audio recordings and/or statements made by me and I waive any claims that I have or may have based on its usage of them or any works derived from them.
License: As to the Creative Works, I hereby grant to Alliance a world-wide, non-exclusive, royalty-free, irrevocable, sublicensable and transferable license to use, distribute, modify, reproduce, publicly perform and publicly display the Creative Works and any related materials for any and all purposes and in all media.
Release and Warranty. I hereby release and hold harmless the Alliance from all damages and liability that may arise from or in connection with the use of my name, Images, audio recordings, statements and/or Creative Works. I warrant and affirm that I own all rights in the Creative Works and have the full legal right and authority to grant the Alliance permission to use them. I further warrant that I have the written consent of each and every identifiable individual person in my Creative Works to use their likeness for the purposes identified herein.
Entire Agreement. This consent form is the sole agreement between Alliance and me regarding my participation in the project and I am not relying on any other oral or written representations made by Alliance.