MAP & CARR"S CIDERHOUSE RELEASE AND LIABILITY FORM
I. LIABILITY RELEASE
I, …………………………..the undersigned, having agreed to act as a model and participant in the aerial photo shoot for food and drink artisans scheduled to take place on September 15, 2013 at CARR"S CIDERHOUSE in Hadley, MA with MY AMERICAN PANTRY (MAP) (hereinafter referred to as the “Activity”) and knowing that there are certain risks and dangers related to this Activity, hereby agree that:
If I am an employee of MAP AND CARR"S CIDERHOUSE , I understand that my activities as a model are within the scope of my employment at MAP AND/or CARR"S CIDERHOUSE
In consideration of my engagement as a model, and for other valuable consideration herein acknowledged as received, I hereby grant MAP AND CARR"S CIDERHOUSE , its agents, representatives, and assigns, the absolute right and permission to copyright and use, re-use, publish, and republish at any time photographic portraits or pictures of me or in which I may be included, in whole or in part, or composite or distorted in character or form, without restriction as to changes or alterations, in conjunction with my own or fictitious name, or reproductions thereof in color or otherwise made through any media at their studios or elsewhere for art, advertising, trade, or any other purpose whatsoever.
I also consent to the use of any printed matter in conjunction therewith.
I hereby waive any right that I may have to inspect or approve the finished product, the advertising copy, or any printed matter that may be used in connection therewith or the use to which it may be applied. To the fullest extent allowed by law I agree to RELEASE, HOLD HARMLESS AND INDEMNIFY MAP ANDCARR"S CIDERHOUSE , its agents, representatives and assigns, and all persons acting under its permission or authority, from any liability by virtue of any publication or use as previously described.
I am over the age of eighteen years of age/or my parent or legal guardian has also read and signed this Release below my signature. I have read the above authorization, release and agreement prior to its execution, am familiar with the contents thereof, and have every right to contract in my own name in this matter.
THE TERMS OF THIS AGREEMENT SHALL ACT A RELEASE AND ASSUMPTION OF RISK FOR MY HEIRS, EXECUTORS, ADMINISTRATORS, AND ALL MEMBER OF MY FAMILY, INCLUDING ANY MINORS ACCOMPANY ME. I UNDERSTAND THIS IS A BINDING CONTRACT THAT SUPERSEDES ANY OTHER AGREEMENTS OR REPRESENTATIONS AND IS INTENDED TO PROVIDE A COMPREHENSIVE RELEASE OF LIABILITY BUT IS NOT INTENDED TO ASSERT ANY DEFENSES WHICH ARE PROHIBITED BY LAW. THE SPECIFIC RIGHTS OF THE PARTIES MAY VARY FROM STATE TO STATE. IF ANY PART OF THIS RELEASE IS DEEMED UNENFORCEABLE, ALL OTHER PARTS SHALL BE GIVEN FULL FORCE AND EFFECT.
I HAVE CAREFULLY READ AND UNDERSTAND THIS AGREEMENT, AND I AM AWARE THAT BY SELECTING "I CONSENT" BELOW, I AM WAIVING CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. I SIGN THIS RELEASE AGREEMENT OF MY OWN FREE WILL.
Date __________________(Print your name) ______________
(Must also be signed by parent or legal guardian if model is a minor)
Parent or Legal Guardian
If I am signing on behalf of a minor, in addition to
the above, I also agree to RELEASE, HOLD HARMLESS
and INDEMNIFY MAP AND CARRS CIDERHOUSE
and their employees, agents and contractors for any claims
of the minor. I agree to be responsible for any medical expenses
incurred by the minor.