Photographic, Video, and Audio Consent and Release Agreement for Publication and Social Media
I hereby give Altarum Institute, its employees, affiliates, and those acting with its authorization, including all vendors, the right and consent to copyright, edit, use, reuse, distribute, and/or publish movies, videotape, quotes, photographic images, narratives, and/or audio of me (and/or my property), and to use such content for Altarum Institute business purposes, which may include public service advertisements and distribution in video format, brochures, print, newspaper, magazine article, internet/intranet, all forms of social media (including, but not limited to, Instagram, Facebook. Twitter) and any other form of media. I further consent that my name and identity may be revealed therein or by descriptive text or commentary and that I am not submitting any information that I consider confidential or proprietary.
I understand that the images and narrative biography of me may be used in public service advertisements to promote recovery/addiction awareness, and that such use may give rise to the impression that I am living with mental illness and/or addiction, I nevertheless consent to this use. I understand that I choose to share such information at my own risk and that Altarum Institute has no control over information I choose to share with others.
I hereby waive any right that I may have to inspect and/or approve the finished product or the advertising copy or printed matter that may be used in connection with my likeness or testimonial or the use to which it may be applied. I agree that I have no rights to the photographs, reproductions, negatives, videos or films, and all rights to such materials belong to Altarum Institute. Further I agree that any uses described herein will be made without compensation or additional consideration.
I hereby represent that my submission to Altarum Institute is original and created by me (not copied), in good taste, legal, accurate and true, non-defamatory, non-threatening, non-confidential, non-proprietary, non-infringing of copyrights owned by others, does not impersonate any person or entity, falsely state or otherwise misrepresent my affiliation with any person or entity, and is relevant for the intended purpose. Altarum Institute may reject your submission, or edit/delete any parts of it that violate this Agreement or edit/delete any parts to improve clarity (e.g., typos)
I understand the information disclosed by this Consent and Release Agreement may be subject to re-disclosure by anyone receiving it, and the information disclosed is not protected by the Health Insurance Portability and Accountability Act of 1996. I hereby release, discharge, and agree to hold harmless Altarum Institute, and those acting with its authorization, including its employees, affiliates, and vendors (including any firm publishing and/or distributing the finished product) from and against any liability, claims, or demands in connection with the above matter.
I am at least 18 years of age and am competent to contract in my own name. I have read this release before signing below and I fully understand the contents, meaning, and impact of this release, and sign this agreement freely and without inducement.