Multimedia Release Form

I voluntarily and without compensation grant a non-exclusive, irrevocable license to Answering T.T.P. Thrombotic Thrombocytopenic Purpura Foundation to the right to use those items selected below, (selected items will be referred to as “Recordings of me”) in the advertising, publicity, or other commercial or business purposes of Answering T.T.P Thrombotic Thrombocytopenic Purpura Foundation in media (“Promotional Materials”) throughout the world.  I understand and agree that I have granted this right to Answering T.T.P Thrombotic Thrombocytopenic Purpura Foundation and its subsidiaries, affiliates, licensees, successors, and assigns, and whomever it or they may further designate.

Without limiting the generality of the rights I have granted to Answering T.T.P Thrombotic Thrombocytopenic Purpura Foundation , I agree that the rights granted include:

  1. to use, reproduce, distribute, publish, sell, lease, rent, lend, display (whether in whole or in part; sequentially or non-sequentially), publicly or privately perform or otherwise commercially use all such Recordings of me;
  2. to edit, abridge, adapt, or reproduce those Recordings of me and combine such Recordings of me with other recordings; and
  3. to use, publish and advertise Recordings of me in any and all manner and medium;

all as Answering T.T.P Thrombotic Thrombocytopenic Purpura Foundation may determine without restriction.

I irrevocably consent to any and all uses, publications and reproductions of the Recordings of Me, waive any right, including without limitation moral rights, which I may have to restrain any such use, publication or reproduction, or to inspect or approve the finished photograph, audio, video, multimedia, or advertising copy or printed matter or computer generated scanned image and other electronic media that may be used or to the eventual use that it might be applied, or to remuneration therefor, and release Answering T.T.P Thrombotic Thrombocytopenic Purpura Foundation and any other person who, exercising rights derived from the Foudation, uses, publishes or reproduces the Recordings of Me

I hereby release, discharge and agree to save harmless Answering T.T.P Thrombotic Thrombocytopenic Purpura Foundation, its agents, representatives, licensees, successors, assigns, employees or any person(s) or corporation(s), acting under its permission or authority, or any person(s) or corporation(s) for whom it might be acting, including any firm publishing and/or distributing the finished product, in whole or in part, from claims relating to rights of privacy, publicity, confidentiality, defamation, copyright infringement and any other causes of action, debts, accounts, contracts, claims and demands whatsoever which I or my heirs, executors, administrators or assigns can, shall, or may have at any time as a result of any act, matter or thing whatsoever arising out of or in connection with the consent and authorization given by me in this release.  I acknowledge that I have read the foregoing and warrant that I fully understand the contents.

By clicking "Yes, I agree" I have voluntarily and without compensation grant a non-exclusive, irrevocable license to Answering T.T.P. Thrombotic Thrombocytopenic Purpura Foundation to the right to use my full name.
By clicking "Yes, I agree" I have voluntarily and without compensation grant a non-exclusive, irrevocable license to Answering T.T.P. Thrombotic Thrombocytopenic Purpura Foundation to the right to use my image/likeness.
By clicking "Yes, I agree" I have voluntarily and without compensation grant a non-exclusive, irrevocable license to Answering T.T.P. Thrombotic Thrombocytopenic Purpura Foundation to the right to use my personal story.
By clicking "Yes, I agree" I have voluntarily and without compensation grant a non-exclusive, irrevocable license to Answering T.T.P. Thrombotic Thrombocytopenic Purpura Foundation to the right to use audio or visual recordings of me.
Files must be less than 2 MB.
Allowed file types: txt pdf doc docx.
Files must be less than 2 MB.
Allowed file types: gif jpg png bmp.
Files must be less than 32 MB.
Allowed file types: mov mp3 zip mp4.