Talent Release Form

For purposes of and in connection with the following project or event  ___________________________________________________  undertaken by ________ at the University of North Carolina at Charlotte (UNCC):

•  I agree to the use of my name, voice, image, or likeness in connection with the above project. Such use may include film, audio tape, video tape, audio-visual work, photograph, illustration, animation, or broadcast, in any media, now known or later developed, for the benefit of UNCC.  I further consent to the use of my name, voice, image, or likeness in any advertising or promotional material created or used in connection with ____________ .  All such items produced will be considered a “Work” for purposes of this agreement.

•  I irrevocably assign to UNCC any and all claims of copyright I may have in and to all “Works” as defined in this agreement.  As copyright holder, UNCC will possess the exclusive right to reproduce, display, modify, perform, or distribute the “Works” in any medium now known or later developed.

•  I hereby release, discharge, and agree to hold harmless UNCC, its legal representatives and assigns, all persons acting under its authority, and those for whom it is acting, from all claims, causes of action and liability of any kind, now known or unknown, in law or in equity, based upon or arising out of use of the “Works” or this agreement including, without limitation, claims of libel, slander, invasion of privacy, right of publicity, defamation, trademark infringement, and copyright infringement.

•  If I am an enrolled student, I understand that this release constitutes a waiver of my privacy rights under the Family Educational Rights and Privacy Act (FERPA).  This release is effective on the date written below and will remain in effect indefinitely.

•  I represent and warrant that I am over the age of eighteen (18) years, and that the authorizations and rights granted hereunder do not conflict with or violate the rights of any third party.

•  This agreement will be binding upon my heirs, successors, representatives, and assigns.

Date:

________________           ________________________________________________

(signature, parent or legal guardian if under 18 years)

Name: ______________________________________________________________

Address: ____________________________________________________________

_____________________________________________________________________

Telephone: __________________________________________________________

Email: _______________________________________________________________