I, as the legal parent or guardian of the child listed below,
irrevocably consent for myself and Minor Child to any and all uses and
displays of my or Minor Child’s name, image, likeness, appearance, basic
biographical information, audio/video recordings, writings, artwork,
and the like, in original form or in modified form, in whole or in part,
in, on, or in connection with merchandise, advertising, publicity,
marketing, fundraising, and the like, in printed or electronic media, of
any type, throughout the world at any time by Big Brothers Big Sisters
of America and Big Brothers Big Sisters of Metro Milwaukee in their sole
discretion, and by any of their affiliates, successors, partners,
sponsors, donors, any entities or persons with whom they conduct any
public relations, marketing, or fund raising of any type, and any other
authorized third parties, without further consent from me or Minor
Child, without any royalty, payment, or other compensation to me or
Minor Child, and with the release and waiver of any claims, actions,
damages, losses, costs, expenses and liability of any kind arising from
any such use (the “Released Material”).
In consideration of the
mutual promises made herein, and for other good and valuable
consideration, the receipt and sufficiency of which I hereby
acknowledge, I hereby grant to BBBSA and its affiliates the right to use
the Released Material as BBBSA and/or its affiliates may desire, in all
media now existing or hereafter created and in all variations and forms
including, but not limited to, internal or external publications or
productions, informational or recruitment materials, marketing
materials, fundraising materials, televised photography and/or
recordings, advertisements, Public Service Announcements, and/or online
and social media sites. The use of this information shall be at the sole
discretion of BBBSA and/or its affiliates.
I further grant to
BBBSA and its affiliates the absolute right to use the Released Material
in whole or in part, alone or in conjunction with any other image,
name, writings or reproduction, in color or otherwise, for art,
advertising, business, trade, or any other lawful purpose whatsoever, in
perpetuity throughout the world.
I understand and agree that all
materials created by BBBSA and/or its affiliates that use the Released
Materials are the property of and are owned by BBBSA, and that I cannot
authorize their use by any other party. I further understand that BBBSA
may authorize their use by a third party. I hereby irrevocably transfer
and assign to BBBSA my entire right, title and interest, if any, in and
to the Released Materials and all copyrights in the Released Materials
arising in any jurisdiction throughout the world, including the right to
register and sue to enforce such copyrights against infringers.
I
acknowledge and agree that I have no right to review or approve the
Released Materials before they are used by BBBSA and/or its affiliates,
and that BBBSA has no liability to me or Minor Child for any editing or
alteration of the Released Materials or for any distortion or other
effects resulting from BBBSA’s and/or its affiliates’ editing,
alteration or use of the Released Materials. BBBSA has no obligation to
use the Released Materials or to exercise any rights given by this
Consent and Release Form.
I hereby release BBBSA and its
affiliates, employees, and agents, as well as any partner companies,
from all claims, demands or liabilities and related financial costs that
I or Minor Child may now or hereafter have arising in connection with
BBBSA’s exercise of the rights hereby granted, and/or with the
appearance or the Released Materials in any publication or production.
These include, without limitation, claims for compensation, defamation,
or invasion of privacy, or other infringements or violations of personal
or property rights of any sort whatsoever.
I have read this
Media Consent and Release Form completely and I fully understand what it
means. I have not been offered any additional consideration or
enticement, nor have I been coerced to sign this document. I am
voluntarily signing it for the purposes and considerations described.
You
have the right to revoke your consent at any time for the collection and use of
your child’s information. If you would like to revoke your consent, please
provide a written, signed statement of revocation and mail it to: Big Brothers
Big Sisters of Metro Milwaukee, 788 N Jefferson Street Suite 600, Milwaukee, WI
53202.