Photo/Video/Audio License and Release Form

For good and valid consideration, receipt whereof is hereby acknowledged, I hereby agree as follows:

             1.          I authorize Miller Theatre and the Arts Initiative at Columbia University to use my likeness and any video, audio, photographs and other reproductions of me in their Morningside Lights materials and for other purposes.  I hereby give and grant to Miller Theatre and the Arts Initiative at Columbia University, its employees, licensees, assigns  and agents, (collectively “Miller and Arts Initiative”) , the right to use my films, photographs, videos, and audio recordings, and to use my likeness in connection therewith, for any purposes it deems appropriate, including but not limited to in any and all Morningside Lights  materials, in any and all media, whether now known or hereafter devised, and specifically including without limitation in and on any and all web sites owned and/or operated by Miller Theatre and Arts Initiative, provided however, Miller Theatre and Arts Initiative will not use the films, photographs, videos, and audio recordings for commercial or for-profit purposes.

2.          I hereby release any and all rights I may have in the films, photographs, videos, and audio recordings, and waive any right to inspect or approve the finished films, photographs, videos, and audio recordings or any printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown. I further waive any right to royalties or other compensation arising from or related to the use of the films, photographs, videos, and audio recordings.

3.          By executing this Release, I waive all rights to claim that any use of my name or likeness by Miller Theatre and Arts Initiative consistent herewith violates any rights of privacy or publicity I might otherwise have had, pursuant to statute or at common law.

4.          I represent and warrant that I have the necessary rights to grant this license and these rights to Miller Theatre and Arts Initiative, and that this license does not conflict in any way with any existing commitments on my part.

5.          Nothing herein will constitute any obligation on the part of Miller Theatre and Arts Initiative to make any use of the rights granted by me herein.

By checking the box on this submission form, I, consent that the films, photographs, videos, and audio recordings of my voice or image may be used by Miller Theatre and Arts Initiative.