Video Release Form

The undersigned enters into the following agreement with Dr. Beth Halbert. I have been informed that Dr. Beth Halbert is capturing footage and that my name, likeness, image, voice, appearance and/or performance is being recorded and made part of the recording in which I appear.

 

  1. I grant Dr. Beth Halbert and its designees the right to use the Product in any format, now known or later developed. I grant, without limitation, the right to edit, mix or duplicate and use or re-use Product in whole or in parts as Dr. Beth Halbert may elect. Dr. Beth Halbert or its designees have complete ownership of the Product, including copyright interests.
  2. I grant Dr. Beth Halbert and its designees the right to broadcast, exhibit, market and otherwise distribute the Product, in whole or in parts, and alone or with other products, for any purpose Dr. Beth Halbert or its designees determine. This grant includes the right to use Products for promoting or publicizing.
  3. I have the right to enter into Agreement and am not restricted by commitments to third parties.
  4. Dr. Beth Halbert has no financial commitment or obligations to me because of Agreement.
  5. In consideration of all the above, I hereby acknowledge receipt of reasonable and fair consideration from Dr. Beth Halbert. I have read, understand and agree to all the above and that the rights granted Dr. Beth Halbert herein are perpetual and worldwide: