Mission Critical Health is a publisher of evidence-based educational content.

Pre-production Release Form

Model Release and Copyright Notice

I__________, the undersigned, hereby give Capital Media Group Inc (CMG) [ dba: Mission Critical Health (MCH) ] (here known as "Producer")and its affiliates (and assignees) my full permission to be interviewed, photographed, recorded and/or videotaped, including any performance, in connection with the publication/product/video/website/event described below.

I hereby authorize and grant CMG an irrevocable, royalty-free, perpetual, worldwide, exclusive right and license to copyright, publish, reproduce, exhibit, broadcast, adapt, edit, display, transmit and otherwise use and permit others to use all or any part of such interviews, photographs, recordings, video and/or audiovisual materials in any manner, media or form whatsoever now or hereafter created for [any purpose including promotional and educational purposes only (not for sale or license for a fee), and to use my name [email address, social media handle] and affiliation, as specified below, for identification purposes, without further consent from or compensation to me or any third party, unless prohibited by law.

I represent and warrant that I am familiar with all applicable conflict of interest and outside compensation laws and regulations as well as policies and rules of my employer or institution (if applicable), and the terms of this Agreement and my performance under this Agreement, is and will be in compliance with those laws, regulations, policies and rules.

I understand that CMG may upload, repurpose, post or publish such materials, or any portion thereof, as it sees fit, including without limitation on its publicly viewable websites, YouTube, Vimeo channels, Facebook pages and other websites and social media platforms at CMG’s sole discretion.

I understand that such materials are the sole property of CMG and I hereby waive any right of inspection, review or approval thereof.

Participant agrees the content or production materials they provide to Capital Media Group or Mission Critical Health will not violate or infringe upon the trademark, trade name, copyright, patent, literary, artistic, personal, private, civil or property right or the right to privacy or any other right of any person, firm or corporation. The final video produced by CMG or MCH and the publicity materials delivered by Producer will not contain any material which is copyright protected or libelous.

I hereby release and discharge CMG and its employees, licensees, agents, successors and assigns from any and all claims, demands or causes of action that I may now have or may hereafter have arising out of or relating to any use of my name, comments, voice or image, including without limitation libel, copyright, moral rights, rights of privacy and any claims relating to descriptions of a biographical nature. I understand this release will survive me, and I intend that my estate be bound by this release.

In consideration of all of the above, I hereby acknowledge receipt of reasonable and fair consideration from Producer. I have read the foregoing, understand and agree to its terms and stipulations. We encourage participants to review our editorial guidelines.

Notice To On-Camera Interviews

Mission Critical Health is informative, editorial and educational programming provided to broadcasters and distributors. Therefore, interviewee(s) and participant(s) are asked to complete a model release form. On-Camera interviewees participating in MCH programs or client-related productions agree the video production for which they are interviewed may be edited, at the sole discretion of the Producer, for any and all broadcasts, in any manner or media, in perpetuity, throughout the world. The interviewee explicitly grants to the photographer, the Producer and to his/her assignees and licensees the absolute right and permission to use, edit, broadcast and publish the photograph(s) and/or image(s) referred to above, in which the intervewee is included, in any medium, throughout the world, without any restriction whatsoever as to the nature of the use or publication or as to the copy of any printed matter accompanying the photograph(s) and/or image(s). The participant understands that the photograph(s) and/or image(s) may be altered and patricipant waive the right to approve of any finished product. I understand that I do not own the copyright of the photograph(s) and/or image(s).

I certify that I am over 18 years of age and that I have the full legal right to execute this agreement. Each Mission Critical interviewee or on-camera participant agrees to the above statement.

Copyright Protected Videos, Graphics, and Artwork

All elements provided to the Producer for the production of a video must be accompanied by a completed copyright release form. No copyright protected content herein may be reused or redistributed by electronic or print means without the express written release from the participant or the copyright holder prior to utilization by Producer.

Participant agrees to provide to Capital Media Group or Mission Critical Health completed copyright release forms for each copyright protected item to be utilized within a production. CMG will not violate or infringe upon the trademark, trade name, copyright, patent, literary, artistic, personal, private, civil or property right or the right to privacy or any other right of any person, firm or corporation. The final video(s) produced by Producer and the publicity materials delivered by Producer will not contain any material which is defamatory or libelous.

How do we keep current?

From time to time, CMG may revise this release form at its discretion. We note the date of the policy below, so you know when it was last updated. CMG advises you to check back periodically to review the Privacy Policy and Release Forms because users of the site will be prospectively bound by the then-current version of this Privacy Policy.

Updated March 2019

info@cmghd.com Psalm 90:17.

Phone

561-304-2939

E-Mail

info@missioncriticalhealth.com

Schedule

A Call with a Producer