White Bear Events/Manitou Days ♥ 4701 Highway 61, White Bear Lake, MN
55110 ♥ www.manitoudays.org. Video Release. Name: Title of Video: Telephone
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2013 Video Contest Video Release Name:
Title of Video:
Telephone Number:
Email Address:
Mailing Address: Organization/Club/School: (If applicable) Names of all participants in the video, as well as those who worked on the video (such as the editor, director, writer, etc.)
1. In exchange for allowing the video that I submitted to White Bear Events/Manitou Days and Explore White Bear to be considered for display on www.manitoudays.com or on other websites in the promotion of White Bear Lake, I hereby grant White Bear Events/Manitou Days and Explore White Bear, their licensees and assigns, a non-exclusive, worldwide, royalty-free, perpetual license to use, reproduce, publish, display and edit the enclosed artwork, in whole or in part (“Use”), with or without my name identification, in any and all media (whether now known of hereafter devised) for commercial, business, and trade purposes, as well as for advertising, marketing and/or publicity purposes. 2. I hereby represent and warrant that: (a) I am 18 years of age or older (or, if not, that a parent or legal guardian will sign on my behalf); and (b) the use of the artwork will not, and this Video Release does not, violate any copyright, trademark, right of privacy, or any other right of any third party, nor be contrary to law, and no third party consent or permission is required for such Use of the artwork. If such permission is required consent must be in writing at time of submission. I agree to release and indemnify White Bear Events/Manitou Days and Explore White Bear from any claims, actions, liabilities, losses, or expenses of any kind (“Claims”) arising out of use of the video or any breach or alleged breach of this Video Release. Signature: ______________________________________________________ Date: ___________________________ I am the parent/legal guardian overseeing of the above minor and consent to this agreement on his/her behalf: Guardian Signature: ______________________________________________ Date: ___________________________ Print Name: _______________________________________________________________________________ White Bear Events/Manitou Days ♥ 4701 Highway 61, White Bear Lake, MN 55110 ♥ www.manitoudays.org
