AUTHORISATION AND RELEASE

“Me and My FASD”

I hereby grant to the National Organisation for FASD (formerly NOFAS-UK, referred to as “National FASD” below) and to its licensees, assignees and other successors-in-interest the non-exclusive right as set forth herein, and to my appearance, image, likeness, performance, voice and/or name and the results and proceeds thereof (my “Performance”) solely in connection with the programme with working title “Me and My FASD” (subject to change).

I hereby authorise National FASD to use this recording I am submitting/or to record (on film, tape, digital, electronic or otherwise) my Performance; to edit my Performance at National FASD’s sole discretion and to include it with the performance of others and with special effects, sound effects and music; to make multiple recordings of my Performance and to use and re-use my Performance, in whole or in part, in any of National FASD’s traditional, non-traditional and social media broadcast formats, worldwide, as well as National FASD’s print and electronic publications and/or in any other mode or manner, not set forth herein, but which may be utilized by National FASD at some future time.

I authorise National FASD to use in whole or in part, to use such recordings for purposes of publicity, advertising and promotion or other non-commercial purposes; and to use my name, likeness, voice, biographic or other information concerning me in connection with National FASD in its sole discretion. I understand and agree that National FASD and its distributors own all rights and proceeds to the recording rendered in connection therewith.

I hereby release, discharge, indemnify and hold harmless, National FASD, its employees, agents, licensees, successor and assigns from any and all claims, demands or causes of action that it may have or may from now on for defamation, invasion of privacy or right of publicity, infringement of copyright or trademark, or violation of any other right arising out of or relating to any utilization of the rights granted under this agreement.

I understand and agree that I am to receive no compensation for my appearance on or participation in the Programme.

All rights, licenses and privileges herein granted to National FASD are irrevocable and not subject to rescission, restraint or injunction under any circumstances. Nothing herein shall be construed to obligate National FASD to produce, distribute or use any of the rights granted herein.

This Authorisation and Release shall be construed according to the laws of the United Kingdom where jurisdiction shall lie with the venue in the county of Greater London. I hereby waive jurisdiction and venue in any other place. This agreement contains the entire understanding of the parties relating to the subject matter.