The Road to Rediscovery - Guest Agreement & Release

• The guest does hereby consent to the recording and distribution of reproduction(s) of the Guest's voice and performance as part of the media program entitled “The Road to Rediscovery” (herein referred to as the "Program"). This is to confirm that the undersigned has agreed to be interviewed or otherwise participate in the Program, a production of the “The Road to Rediscovery”.
• As a condition of publication/broadcast and for no monetary compensation, “The Road to Rediscovery” requests the non-exclusive worldwide rights to reproduce, distribute, and sell your oral and/or video presentation, in whole or in part, in any media, as part of this Program published under the auspices of “The Road to Rediscovery” and to license these rights to others, in perpetuity. “The Road to Rediscovery” shall have the right to edit and/or transcribe your presentation.
• You also grant “The Road to Rediscovery” the right to use your name, biography and likeness in connection with the Program.
• You warrant that your presentation is original with you, that publication/broadcast will not infringe on the rights of others, and that you have full power to grant this license. Should your presentation/broadcast incorporate copyrighted materials of others, you warrant that you have obtained such permission from those parties for publication/broadcast by “The Road to Rediscovery”, consistent with this Agreement.
• If the foregoing terms are satisfactory, please sign and date this agreement below and return it to the Program coordinator. Execution of this Agreement does not obligate “The Road to Rediscovery” to publish your presentation or other materials.
• I hereby consent to the use of my oral and/or video presentation as described and agree with the provisions of this release form.