PODCASTING, PHOTOGRAPHIC, AND OTHER MEDIA
CONSENT AND RELEASE FORM
I authorize and grant to the University of the Incarnate Word (UIW), St. Anthony Catholic High School, Incarnate Word High
School, and UIW Prep, all of which are referred to collectively in this agreement as UIW, and those acting pursuant to its
authority, a non-exclusive, perpetual, worldwide license to:
1. Record my participation, likeness and/or voice on a video, audio, photographic, digital, electronic, hosted media, web-
based service or any other medium, including podcasting;
2. Use my recorded likeness and/or voice on a video, audio, photographic, digital, electronic, hosted media, web-based
service or any other medium, including podcasting;
3. Use my name and identity in connection with these recordings;
4. Use, reproduce, exhibit, or distribute in any medium (e.g. print publications, video tapes, CD-ROM, Internet, podcast
)
m
y recorded likeness and/or voice on a video, audio, photographic, digital, electronic, or any other medium withou
t
r
estrictions or limitations for any educational or promotional purpose which UIW and those acting pursuant to it
s
a
uthority, deem appropriate, including promotional efforts.
5. Distribute the medium over the internet using formats that allow downloading and playback on mobile devices and
personal computers, for the purpose of making the work available in any format through ITunes or other web-based
service
.
6
. Make and maintain more than one copy (hard-copy and/or digital copy) of the work for purposes of security, back-up
and preservation.
I r
elease UIW and those acting pursuant to its authority, from liability for violation of any personal, intellectual (including
copyright) or proprietary rights I may have in connection with uses of the recordings authorized above. To the extent
required, I hereby grant and assign all copyright in the podcast, video, audio, photographic, digital, electronic, or any other
medium utilized to UIW. I waive any right to inspect or approve the final use(s) of the video, audio, photographic, digital,
electronic, podcast or any other medium. As to the video, audio, photographic, digital, electronic, podcast itself, or any other
medium, I understand and agree that UIW shall have exclusive ownership of the copyright and other proprietary and property
rights in the work.
I
waive any rights, claims, or interests I may have to control the use of my likeness, voice, name, recordings, and/or identity in
the recordings and podcasts authorized above. I agree that any uses described above may be made without compensation or
additional consideration to me. I agree that UIW shall have the right to remove the work from the hosted media or web-based
service at anytime without prior notice for any reason deemed to be in UIW’s best interest.
I w
aive and release UIW and its officers, agents and employees from any claim or liability relating to the use of my name,
likeness, identity, voice, photographic image, video graphic image and oral or recorded statements in the work, including all
claims of compensation, damage for libel, slander, invasion of the right of privacy or any other claims based on, arising out of,
or connected with the use of said recordings and podcasts. I agree to indemnify UIW and its officers, employees, agents,
successors, heirs, and assigns, for any and all claims, liabilities, damages, and expenses, including reasonable attorneys' fees
actually incurred, due to any claimed infringement of copyrights, trade names, trademarks, service marks, right of publicity or
privacy, or other proprietary, personal or property right arising from publication of the work through the hosted media or as a
result of my breach of any covenant or warranty herein contained.
T
his Agreement shall be governed by and interpreted in accordance with the laws of the State of Texas.
B
y my signature, I represent that I have read and fully understand the terms of this release. (A parent or guardian of youth
under 18 must also sign.)
N
ame (print): ______________________________________________
Date of Birth:
E-mail Address:__________________________________________
Home Phone: ____________________________________________ Cell Phone:
Signature: ____________________________________ Date: _______________
I HAVE CAREFULLY READ THIS CONSENT AND RELEASE FORM AND AGREE TO ITS TERMS ON MY BEHALF AND ON BEHALF OF
THE MINOR CHILD IDENTIFIED ABOVE.
___
_________________________________________ _ Date: _______________
Signature of Parent/Guardian (of youth under 18):
Name of project: __________________________________ Date: _______________
2021-2022 Endowed Scholarship
