Media Consent and Release Form *
For valuable consideration, the receipt and adequacy of which I acknowledge, I irrevocably give to AT&T Services, Inc., its parent, subsidiaries, affiliates, related companies and any of its legal representatives, agents, licensees, permitees, or assigns (“AT&T”), the perpetual, worldwide, exclusive license, right, and permission to copyright and/or trademark in the name of AT&T and to use in any form or fashion, including, but not limited to, advertising, publicity and all other purposes deemed appropriate by AT&T, my name, signature, picture, image, likeness, voice, poses, plays, appearances, movements, or any other indicia of my identity or activity of any nature created, depicted, captured or recorded by or at the direction of AT&T (collectively, “Materials”) in or in connection with any and all media of any kind and nature now known or developed in the future (collectively “Media”), for any purpose, in any manner, without further notification, authorization or compensation to me or anyone acting on my behalf. I understand that AT&T may use all Materials at its sole discretion and that I do not have any right to inspect or approve the use of the Materials in any Media. AT&T may transfer all of the rights granted by this Media Consent and Release Form. I further waive, assign and release to AT&T all rights associated with the Materials and release AT&T from any liability associated with the Material or AT&T’s use of the Materials in any Media. If material including my image/likeness/voice should be made into a video or commercial and fall within the definition of Principal Performer under the applicable SAG/AFTRA Agreement (“Agreement”), I agree to be bound by the terms and conditions of such Agreement and to accept compensation at the applicable scale rates.
I confirm that the statements I make about AT&T services and / or AT&T network in the Materials are true and an accurate expression of my personal experience and belief regarding the AT&T services and/or AT&T network.
I am over eighteen (18) years of age (nineteen in Alabama and Nebraska; twenty-one in Mississippi and Puerto Rico) and I have full legal capacity to grant this consent and release, and have read and understood the above consent and release prior to its execution. If I am under eighteen (18) (nineteen in Alabama and Nebraska; twenty-one in Mississippi and Puerto Rico) years of age, my parent or guardian attests that he or she has read and understands the above consent and release prior to execution, and agrees to such consent and release. This release is made on behalf of myself, my heirs, executors, administrators and assigns and is to be governed in accordance with the substantive laws of the State of Texas without regard to the state’s conflict of laws rules.