PARTICIPATION AGREEMENT AND RELEASE

PARTICIPATION AGREEMENT AND RELEASE
(For Minors)
As parents/guardians of ________________________________________________________,
we (I) hereby grant consent to the Los Angeles Unified School District, a royalty-free,
non-exclusive and irrevocable license to produce or reproduce audio tapes, videotapes,
DVDs, and/or photographs in which our son/daughter participates.
We (I) understand that our son/daughter will not receive any monetary compensation,
now or in the future, for his/her participation in the television production.
We (I) hereby indemnify the Board of Education of the Los Angeles Unified School
District, its officers and employees against any action brought by our child as a result
of the audio tapes, videotapes and/or photographs herein consented to.
We (I) further grant permission to the Los Angeles Unified School District to make
unlimited educational use of such materials, including, but not limited to, the sale of
videocassettes, broadcasting to the public over radio and television stations, video
streaming, and posting on the Internet.
Dated and signed this __________________ day of ___________________________, 2016,
in the City of ________________________, County of Los Angeles, State of California.
____________________________
______________________________
Print Name
Signature
_________________________________
Address
____________________________________
City, State
KLCS PARTICIPATION AGREEMENT AND RELEASE_2016
PARTICIPATION AGREEMENT AND RELEASE
In consideration of my participation in the video production,
I, __________________________________________________________ hereby consent to the
taping, recording, or the reproduction in any manner, of my likeness or voice, including
the use of videotapes, DVDs and audiotapes.
I further authorize the Los Angeles Unified School District, its agents or assigns, to
make unlimited educational use of such reproductions, including, but not limited to, the
sale of video/audio cassettes, DVDs, broadcasting to the public over radio and
television stations, video streaming, and posting on the Internet.
I understand that I will not receive any monetary compensation, now or in the future,
for my participation in the television/video production.
I do hereby release and hold harmless the Los Angeles Unified School District, its
officers and employees, from any claims.
Dated and signed this __________________ day of ___________________________, 2016,
in the City of ________________________, County of Los Angeles, State of California.
____________________________
______________________________
Print Name
Signature
_________________________________
____________________________________
Address
City, State
KLCS PARTICIPATION AGREEMENT AND RELEASE_2016
TRATADO DE PARTICIPACION Y RENUNCIA
Como padres/guardianes de ________________________________________________,
nosotros (yo)damos consentímiento al Distrito Unificado de Los Angeles, el cual otorga
licencía al canal de Televisión Instruccional, el canal KLCS, libre de derechos, noexclusivo y con licencía irrevocable, para producir o reproducir grabaciones de audio,
DVDs, video y o fotografía en las cuales participen mi hijo o hija.
Nosotros (yo) entendemos que nuestro hijo (a) no recibirá compensación monetaria,
ahora o en el futuro, por su participación en la producción del programa.
Nosotros (Yo) por este acto indemnizamos a la junta de educación del Distrito Escolar
de Los Angeles, sus oficiales y empleados contra cualquier demanda presentada por
nuestro hijo(a) como resultado de las grabaciones (audio-video) y fotografías ya
mencionadas dentro de nuestro consentimiento.
Además, otorgamos permiso al Distrito Escolar de Los Angeles el uso ilimitado
educacional de dicho material, incluyendo la venta de grabaciones de video y la difusión
al público por otras estaciones de radio y televisión.
Firmado el ______________________ de ________________________________, del año 2014,
en la ciudad de ________________________, condado de Los Angeles, estado de California.
______________________________
Nombre (en letra de molde)
_______________________________
Firma
___________________________________
_____________________________________
Domicilio
Cuidad, Estado,Código Postal
KLCS PARTICIPATION AGREEMENT AND RELEASE_2016