Permission and Release Form to Videotape Guest Lecturer/Presenter
VIDEOTAPING PRESENTATIONS
PERMISSION AND RELEASE FORM
Event:
_________________________________________________________________________
Please
checkmark Yes/No for all questions 1-3. This form also requires
your signature on page two.
1.
I have the
necessary rights and/or permissions to use the works of others.
Yes ________
No ________
2.
I am willing
to have my presentation available on Centre’s website, iTunes University, or
any other
on-line
video streaming service managed by Centre College.
Yes
________
No ________
3.
I am willing
to have my presentation available on any Centre’s web presence, only if access
is limited
to individuals
who work/attend Centre College.
Yes
________
No ________
I understand that this event is being videotaped,
and I hereby grant permission for Centre College to include my presentations
and comments, in any and all forms, in these records and recordings. I further grant permission for Centre College
to transcribe and reproduce these records and recordings, if Centre College
chooses to, and for Centre College to distribute and/or make multiple copies of
these records, recordings and transcripts, in complete or partial form, and in
translation, on videocassette, broadcast, cablecast, CDROM, laser disc,
multimedia, print, electronic text, and any other media format now or hereafter
known.
I agree that Centre College has the right to use my
image, voice, pronouncements, and likeness recorded herein, and my name and any
and all biographical material submitted by me in connection with the Event
named above, for purposes of the reproduction and distribution described above,
and for any associated advertising or exhibition, whether used in excerpts or
in full.
I understand that Centre College and others will
invest considerable resources in reliance on the permissions and releases
herein. I understand that Centre College
is under no obligation to exercise any or all of the rights, licenses, or
privileges herein granted. I hereby
release and discharge Centre College and other Event sponsors, funders, and
organizers from any and all liability arising out my participation in the
Event, or in connection with the performance of any of the activities described
in this document as permitted herein, including but not limited to my rights of
privacy or publicity, copyrights, patent rights, trade secret rights, moral
rights, or trademark rights.
All permissions granted by me and all releases by me
herein shall be effective in perpetuity and throughout the universe. All permissions and releases herein extend
and apply to Centre College and its assigns, contractors, sublicenses,
distributors, successors, and agents.
In the event that any materials used in my
presentation contain the work of other individuals or organizations (including
any copyrighted musical compositions or excerpts thereof), I understand that it
is my responsibility to secure any necessary permissions and/or licenses. Small
performing rights licenses must be secured for the public performance of any
copyrighted musical compositions in film or video presentations.
____________________________________________ ________________
Signature Date