This portion of the form asks about general health information that is important for us to know about your skater.
NJRD PHOTO & VIDEO RELEASE AGREEMENT
For consideration which I acknowledge, I irrevocably grant to The Nashville Junior Roller Derby League, licensees, assigns and successors the right to use my image and (skater) name in all forms and media including composite or modified representations for all purposes, including advertising, trade or any commercial purpose throughout the world and in perpetuity. I waive the right to inspect or approve versions of my image used for publication or the written copy that may be used in connection with the images. I relinquish any right that I may have to examine or approve the completed product or products or the advertising copy or printed material that may be used in conjunction therewith or the use to which it may be applied. I release, licensees, assigns and successors from any claims that may arise regarding the use of my image including any claims of defamation, invasion of privacy, or infringement of moral rights, rights of publicity or copyright. Nashville Junior Roller Derby League is permitted, although not obligated, to include my name as a credit in connection with the image.
I have read and understood the photo release agreement. I (the undersigned) do hereby confirm the consent heretofore given you with respect to your photographing me or my child in connection with any Nashville Junior Roller Derby video. Additionally I hereby grant to you, your successor, assigns and licensees the perpetual right to use, as you may desire, all motion pictures and sound track recordings which you may make of me or my child, and the right to use my name and/or child’s name or likeness in or in connection with the exhibition or any other use of such video or recording.