Participant Release & Consent Form

I hereby grant to Lower Manhattan Cultural Council, Inc. (“LMCC”), a New York not-for-profit corporation with a principal address of 125 Maiden Lane, 2nd Floor, New York, NY 10038, and its licensee, successors and/or assignees, the perpetual, worldwide, non-exclusive, royalty free, right (which shall not be deemed as obligation) and license, throughout the universe, to:

  • Record my participation and appearance by any means and media whatsoever, including, without limitation, any digital or film photography, video tape, audio tape, or any other media (collectively, the “Recording”) for the purpose of realizing a literary work tentatively entitled “LMCC’s Poetry Project” (the “Work”);
  • Use my name, likeness, voice and biographical material in connection with the Work;
  • Copy, record, reproduce, adapt, edit, modify, elaborate, transform, delete, title, subtitle, dub, translate, advertise, publish, sell, vend, rent, lease, license, distribute, transmit, broadcast (by terrestrial, cable, satellite, wire, wireless, or any other means now known or later devised), rebroadcast, perform, utilize, use, reuse, promote, advertise, market, derive revenues or otherwise exploit, with the fullest extent, publicly display and/or publicly perform, in print, electronic or any other medium, now known or later devised, by any means and media of exploitation, none excluded, including, without limitation, theatrical, non theatrical, television (terrestrial, cable, satellite, wire, wireless, etc.), radio broadcasting (analog, digital, etc.), recording (cassettes, CD, discs, MP3 and similar electronic formats, storage devices, etc.), home video (videocassettes, CD, DVD, etc.), pictures, still photographs, Interactive and Multimedia (CD-Rom, Internet, webcast, simulcast, streaming, downloading, via www, etc.) copies of the Recordings, of the Work and of any and all works derived from the Recording and/or the Work, in whole or in part, in its integrity or by excerpts, in video and/or in audio, alone or coupled together with other audiovisual materials, including the right to print, copy, publish, in traditional form and/or by means of electronic publishing, the content, declaration, representations included in the Recording, including, without limitation, the right publish the above content, declaration, representations in any language worldwide and throughout the universe, and in general for any lawful purpose whatsoever;

I represent that I have the necessary title and rights to grant this permission for and in connection with the above provisions and therefore I guarantee and hold harmless LMCC in connection with the representation that this present grant of rights and license does not conflict with any other rights, title and/or interest of any third parties, and I agree to release and forever discharge LMCC, its board members, officers, agents, employees, volunteers, and designated representatives, from any and all claims in law or equity that I, my heirs or personal representatives, as well as any other third parties have or shall have, arising out of Recording and the Work.

In consideration of my participation in the Work, I expressly declare and represent to deem such consideration as good and equitable and therefore I waive any further right under law or equity into any further and/or additional compensation whatsoever, acknowledging that any copyright, ownership, results, revenues and proceeds derived from the Recording and/or the Works and or any work derived from the Recording and the Work, under any applicable law (and subsequent modifications and integrations) or equity, shall be throughout the universe in perpetuity the sole and absolute property of LMCC, and its licensees, successors and assignee, and registered and protected in their name.

This Agreement shall be governed by and construed under the laws of the State of New York, without regard to conflicts of law principles.

I UNDERSTAND AND AGREE WITH THE CONTENTS OF THIS DOCUMENT.  ANY QUESTIONS I MAY HAVE HAD ABOUT THIS DOCUMENT WERE ANSWERED TO MY SATISFACTION.

A PARENT OR LEGAL GUARDIAN MUST AGREE TO THE TERMS AND CONDITIONS IF THE PARTICIPANT IS UNDER 18 YEARS OLD.