Authorization and Photo/Video/Interview Release Agreement
I understand and agree that in consideration of my being allowed to engage with representatives from the American Heart Association (“AHA”), I consent to and permit AHA to take and use video and voice recordings and photographs taken of me or provided by me to the AHA for the purpose of promoting AHA’s mission, its programs and activities (“Images”). “Use” includes publishing such Images for such purpose in any medium, including in social media and may include use of my image and likeness, my voice only, or excerpts from any interview or presentation. I understand that such Images and the copyright therein shall be solely owned by AHA, and AHA shall have the right in perpetuity to duplicate, reproduce, adapt, modify, create a derivative work from, and publicly display such Images.
I may also provide information about my personal experience with the understanding that I am providing information about my personal experience with cardiovascular disease or stroke that identifies me and that might describe my past or present mental or physical condition. I grant the AHA the right to use and disclose this information to the general public in any medium in order to serve the purpose of increasing public awareness of cardiovascular disease and stroke. I also understand stories under the "By American Heart Association News" byline are available for linking, quoting, excerpting and reprinting by other news outlets, websites and organizations.
The rights I have granted in the Agreement are given without the requirement of providing any attribution or compensating me.
I agree, for myself, my heirs, executors and administrators, to not sue and to release, indemnify and hold harmless AHA, its affiliates, officers, directors, volunteers and employees, from any and all liability, claims, demands, and causes of action whatsoever, arising out of my participation in the Program and related activities, whether it results from the negligence of any of the above or from any other cause. This Agreement is as broad and inclusive as is permitted by the State in which the Program is conducted. If any portion of it is held invalid, the balance will continue in full force and effect. The rights granted the AHA herein are perpetual and worldwide.
I HAVE READ AND UNDERSTAND THIS AGREEMENT, AND I HEREBY AGREE TO ALL OF ITS TERMS AND CONDITIONS, AS EVIDENCED BY MY SIGNATURE BELOW.