The Guest named above 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 “R.A.D.I.O. RESOURCES FOR ALL DISABILITIES IN ONE” (herein referred to as the “Program”). This confirms that the undersigned has agreed to be interviewed or participate in the Program, a production of the Effingham County Navigator Team Inc.

As a condition of publication/broadcast and for no monetary compensation, Effingham County Navigator Team Inc.
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 Effingham County Navigator Team Inc. and to license these rights to others, in perpetuity. Effingham County Navigator Team Inc. shall have the right to edit and/or transcribe your presentation.

You also grant Effingham County Navigator Team Inc. 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 Effingham County Navigator Team Inc., 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 Effingham County Navigator Team Inc. to publish your presentation or other materials.