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Meliza Hernandez
I ASPIRE TO INSPIRE.
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MELIZA SHOW
MEDIA RELEASE
Please complete the form below
Media Release
*
By completing this form I hereby grant permission to the Meliza Show, its employees, agents, representatives, partners, and subcontractors to photograph and video me, and otherwise capture my image and to make recordings of my voice on the assigned date. I further grant the Meliza Show the right to reproduce, use, exhibit, display, broadcast, license, distribute, sell and create derivative works of these images and recordings (collectively my “Photographs and Recordings”) in Meliza Show’s media channels, including but not limited to, internal and external print and/or digital outlets now known or later developed, for purposes of the promotion and marketing of the Meliza Show. I acknowledge that the Meliza Show owns all rights to my Photographs and Recordings. I agree that all of my Photographs and Recordings and any intellectual property therein shall constitute the property of the Meliza Show. I hereby waive any right to inspect or approve the use of my Photographs and Recordings and my name or any written copy in connection with the use of my Photographs and Recordings. I understand and acknowledge that the Meliza Show has no control over and is not responsible for any use or misuse of any of my Photographs and Recordings copied from a website or other media by unauthorized third parties. I release and forever discharge the Meliza Show from any and all claims and demands arising out of or in connection with the use of my Photographs and Recordings. I waive any and all privacy rights, moral rights and any other rights that I have in my Photographs and Recordings. I acknowledge that I am not entitled to, and shall not seek, any compensation fees or royalties of any kind, arising in any way from this consent, in respect of whether my Photographs and Recordings are used or not, and that nothing contained in this consent shall entitle me to have any of my Photographs and Recordings. If I provide an e‐mail address I agree that it may be used solely to provide me with a copy of one or more of my Photographs and Recordings or to contact me in respect of this Consent. Please mark this box if you agree to participate in Meliza Show productions as described above taking place on the date you were assigned.
I Agree
Name
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First Name
Last Name
Email
*
Address
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Address 1
Address 2
City
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Zip/Postal Code
Country
Phone
*
(###)
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Date
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YYYY
Thank you!