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*Story Release Form

In consideration of the opportunity afforded me to participate, perform or appear in, to appear in an interview for and/or to provide materials for the above-noted Publication, I hereby irrevocably grant to the Producer, its successors, assignees and licensees, the following rights throughout the world in perpetuity (the “Rights”):

 (i)the unlimited right to portray me, and to use my written narrative, performance, appearance, interview, name, words, voice, likeness and any musical, instrumental and/or sound effects produced by me (the “Appearance”) and to use any information, material and/or records in any form (including photographs, films, tapes, recordings, notes and documents, etc.) owned or furnished by me (the “Material”) in the Publication or any newsletter, social media post, promotional film, television, video disk, CD-ROM (whether or not interactive) or any other form of written or audio-visual Publication (the “Product”), including any versions or translations thereof;

 (ii) the unfettered right to photograph, film, record and reproduce the Appearance and/or the Material, in whole or in part, by any means now known or hereafter devised, including the right to edit, add to, juxtapose and combine the Appearance and/or the Material in any combination or sequence with or without other material prepared by others and the right to delete any part of the Appearance and/or the Material for use in the Product; provided the Producer shall not alter, electronically or otherwise, my actual words, voice or likeness as recorded in any interview given to Producer; 

 (iii) the right to exhibit, transmit, telecast, broadcast, distribute and otherwise share all or any part of the Appearance, the Material and/or the Product in any and all manner, media, formats, and markets now known or hereafter devised; and (iv) the right to use the Appearance and/or the Material, in whole or in part, in connection with advertising or publicizing the Publication.

 I represent that I am entitled, without any third party approvals, to grant the Rights as set out herein and that such Rights are free of any third party claims or interests. I hereby irrevocably release the Producer, the representatives, agents, employees, successors, assignees and licensees or any of them (the “Releasees”) from any and all claims and demands for any matter related directly or indirectly to the grant or use of the Rights, including without limitation, for invasion of privacy, defamation and any other personal and/or property rights, and I hereby waive the right to seek injunctive or other equitable relief against the Releasees for any such matter. I hereby release the Producer, its directors, employees, licensees and assigns from and of any and all liability for any damages which I may suffer from any injury to my person or property which may result from my participation in the Product;

 (iv) the right to refuse, edit, take down, or censor any part of the Material or the Appearance at any time and for any reason insofar as it appears in the Publication.

I understand that the Producer is and will be relying on the grant of rights made by me herein and thus I confirm that this grant of rights is irrevocable.

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