GO with YOYO - Media Release Form
Please fill in the 4 questions below! Thank YOU!!
Sign in to Google to save your progress. Learn more
Email *
First and Last Name of Child(ren)/Participant(s). Add siblings on same line with a comma separating. *
What video(s) are the participant(s) in? ( You don't have to know the exact name, just something similar - i.e., frog video, unicorn, etc.! THANK YOU!) *
The undersigned, the parent(s) or legal guardian(s) of the child listed (hereinafter “participant”), a minor under the age of eighteen years, hereby agrees, on behalf of myself and on behalf of participant, that photographs, whether still or action, videos, film and/or motion pictures (“Media”), may be taken of participant, individually or with others, by or on behalf of LET’S PLAY TODAY, LLC and Go with YoYo. I further agree on behalf of myself that, without any compensation or notification to or approval by the undersigned, the Media may be used, reproduced or otherwise disseminated or published by or on behalf of LPT or Go with YoYo directly or indirectly for any purpose, including but not limited to advertising and/or educational or promotional purposes, in any manner, and at any time that LPT or Go with YoYo desires.I understand that, during the course of my child(s) (“Participant”) participation in a LET’S PLAY TODAY® (“LPT”) learning experience, or LPT or Go with YoYo and those acting with the permission of LPT, may capture Participants likeness, image, or voice in photographic, audio, video, digital, online and in print or other forms (“Media”). I recognize and agree that all Media and said rights to the same – including film, photographic prints, audio, video or digital files therein shall irrevocably, exclusively, unconditionally and perpetually belong to LPT and Go with YoYo and that such rights are freely assignable to LPT. I hereby permit LPT and those acting with permission from LPT to use such Media for any non-commercial, or commercial, or educational uses. In addition, I understand and agree that LPT and those acting with permission from LPT, may use the Media in materials available to teachers, staff, faculty; including in publicity or promotional materials available for exclusive usage by LPT.I hereby waive any right to inspect or approve: (a) the finished Media, (b) any printed matter that may be used in conjunction with the Media, or (c) the eventual use to which the Media may be applied. My waiver of inspection or approval is only given with the understanding that all Media used by LPT will be that of wholesome, appropriate family oriented production and display.I hereby agree on behalf of myself and on behalf of Participant, to release and discharge LPT, its representatives, employees, independent contractor, licensees, successors and assigns from any and all claims, demands or causes of action that participant may now have or may hereafter have libel, defamation, invasion of privacy or right of publicity, infringement of copyright or violation of any other right arising out of or relating to any utilization of the Media.This agreement constitutes the sole, complete, and exclusive agreement regarding Media, and I am not relying on any other representation, whether oral or written. I represent that I am the Parent/Guardian of the above named Participant and am fully authorized to enter into this Publicity Release on behalf of Participant. PLEASE SIGN YOUR NAME BELOW *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy