Heroes on the Water

Annual Media Authorization, Waiver, and Release

I, the participant or volunteer identified below, by submitting this Media Authorization, Waiver, and Release (“Authorization”) hereby authorize and give my full consent to Heroes on the Water, Inc. and its agents and representatives (“HOW”) to photograph and make video or sound recordings (“Media”) of me during my attendance at any HOW event. I understand that such Media may depict or describe and HOW may otherwise document or describe: my medical condition, if any; my experiences as a service member in the United States Armed Forces, if any, and my experiences with the HOW program (“My Story”). I hereby GRANT HOW the unrestricted right to: •    File for and seek copyright registration of any and all such Media and works created by HOW using my likeness or My Story; •    Publish, re-publish, use, re-use, the Media, my likeness, and My Story in any form including photographs, videos, films, web casts/podcasts, social media posts, blogs, exhibitions, public displays, publications, advertisements, and television programs and any other form of visual/audio communications or displays without limitations or reservations; and •    Edit, alter, modify, for visual, auditory, and substantive effect any of the Media, representations of my likeness, and My Story at HOW’s sole discretion. I hereby WAIVE AND RELEASE HOW from: •    Any claim for copyright, trademark, rights of publicity, right of privacy, authorship, or any other intellectual property or privacy right I may have in the Media, depictions of my likeness, or content containing my story that is created by HOW; •    Any right I may have to inspect or approve the finished product or products of any matter containing the Media, my likeness, or My Story created by HOW; and •    Any right I may have to compensation or any claim for payment or royalties in connection with HOW’s creation of the Media, depictions of my likeness, or content containing My Story and the display or usage of the same. I hereby UNDERSTAND AND AGREE that: •    The rights granted herein to use the Media, my likeness, and My Story shall extend to any reproductions, made through any medium and in any and all forms now or hereafter known whether used singularly or in conjunction with other accompanying material and whether used for any purpose whatsoever, including commercial purposes of HOW; •    That submitting this form is completely voluntary and I am submitting it under my own free will. I understand that my participation in a HOW event will not be conditioned upon my submittal of this form; •    I understand this Authorization may be cancelled at any time by giving HOW notice of cancellation in writing to 101 C North Greenville Avenue, Suite 55, Allen, Texas 75002, Attn: Executive Director; but such cancellation shall only apply to creation of new works after receipt of notice of cancellation and will not prevent HOW’s continued usage and re-usage, including derivatives, of Media and other works created prior to cancellation. •    That my submission of this form through the web-based or other digital application creates a legally binding document, and I intend that the inclusion of my name and submission of this Authorization through the application to constitute my signature and execution of this Authorization. •    That by submitting this Authorization, I am representing and warranting to HOW that I am the person identified on the Authorization, that I am over 18 years of age, and fully capable of executing this Authorization.

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