Consent & License
For my participation in activities to be conducted by West Shore YMCA, and collaborating third
parties, I consent, now and for all time, to the making, reproduction, editing, broadcasting or
rebroadcasting of:
• Video film or footage of me
• Sound track recordings of me
• Photo reproductions of me
• Any narrative account of my experience
My consent includes a perpetual license to the Y and collaborating third-parties for the use of the
above materials for publication, display, sale or exhibition in promotions, advertising, education and
commercial uses. Use includes reproductions in any form and media currently existing or later
conceived, adaptations and/or revisions, throughout the world in perpetuity.
I understand and agree there may be no additional compensation for this license, and I will not make
any claim for payment of any kind from the Y or collaborating third-parties. I may, or may not be,
identified in such licensed uses; however, my name will not be used to endorse any particular
products or services.
Ownership, Confidentiality, and Shared Use.
With respect to any of the above uses, I further agree:
• All works shall belong to the West Shore YMCA;
• The Y has no duty of confidentiality regarding any licensed uses;
• West Shore YMCA, shall exclusively own all known or later existing rights to the uses
throughout the world;
• The Y and collaborating third-parties may use any video film, footage, sound track recordings
and photo reproductions of me and/or my narrative account for any purpose without additional
compensation to me.
Release from Liability
I agree that my consent is irrevocable. I hereby release and discharge The Y and collaborating third parties, from any and all claims, actions, lawsuits or demands of any kind arising out of my consent,
license grants, uses, or the shared uses of any works or materials referenced herein.