Name of Participant (The "Minor")
Surname of Participant
Participant's
Date of Birth
Name & Surname of the Participant's Parent/Legal Guardian
Email Address of the Participant's Parent/Legal Guardian
Phone Number of the Participant's Parent/Legal Guardian
Media Consent & Release Agreement:
I, on behalf of the Minor, grant Hillsong Africa Foundation and Hillsong Church International with its employees, agents, contractors, licensees and assigns, (“Hillsong Africa Foundation”) the right to film and photograph the Minor, record the Minor’s voice, image and likeness and make audio or audio-visual recordings of the Minor by means of any medium or technology (the “Recordings”).
I, the above listed Minor's Guardian, grant Hillsong Africa Foundation & Hillsong Church (herein referred to as “the Producer”) the following:
I have all rights and entitlement necessary to grant this release.
Hillsong Africa Foundation & Hillsong Church fully owns all right, title and interest in the Recordings, including copyright.
Hillsong Africa Foundation & Hillsong Church can use, edit, adapt, communicate and reproduce Recordings or any part of them, including combining them with other recordings or authorising others to do so, in all media throughout the world without restriction or limitation (including for promotional purposes) without my further permission.
Hillsong Africa Foundation & Hillsong Church can use my name, voice, likeness, image and biographical and other information in connection with the Recordings, including for promotional purposes.
Any statements I make that are recorded by Hillsong Africa Foundation & Hillsong Church will be original to me and will not violate or infringe on rights of any person or entity including copyright.
Hillsong Africa Foundation & Hillsong Church is not obliged to use the Recordings otherwise.
I release Hillsong Africa Foundation & Hillsong Church from all claims, demands and actions in connection with or resulting from the exercise of rights granted in this release.
Hillsong Africa Foundation & Hillsong Church is entitled to rely on this release. I waive my rights at any time to seek injunctive or other relief to prevent or restrict Hillsong’s use of the Recordings.
I agree that this consent is valid for 5 years from the date on this form, and I may be given the option to renew consent upon expiry.
I agree that Hillsong Africa Foundation & Hillsong Church shall not pay me any fees or royalties in connection with my contribution to the Recordings;
I will not bring any claim or commence proceedings of any other nature against Hillsong Africa Foundation & Hillsong Church or any other person or entity in respect of the exercise of rights granted in this release.
Declaration:
I am the Parent / Legal Guardian of the Minor represented in this Release Form. I agree to all the terms & conditions of this Release, along with the Minor, and consent to the above. I enter this Participant's Release with the Minor on their behalf.
Signed at (Location)
Today's Date