TALENT RELEASE Please complete the Talent Release Form FORM VIGOUR.MEDIA - Talent Release Form Today's Date Day * 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month * Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Year * 2021 2022 2023 2024 2025 Title * Dr Prof A/Prof Mr Ms Miss Mrs None Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number * Email Address * Qualification(s) in full * Years of Experience in your field of expertise If Applicable Company Name you are representing Your Position Upload Documents (10MB max) FileField;MaxSize=10000;Multiple;addText=>>_click_here_to_add_your_file; Release I hereby assign and grant to Black Sparrow Group P/L trading as Vigour.Media (Black Sparrow Group) ownership and the right and permission to use and publish the photographs /film / videotapes / electronic representations and/or sound recordings made of me by Black Sparrow Group, and I hereby release Black Sparrow Group from any and all liability from such use and publication. I hereby waive all personal rights and objections to, including the right to inspect, any use of the said photographs / film / videotapes / electronic representations and/or sound recordings by Black Sparrow Group. I hereby agree to release, defend, and hold harmless Black Sparrow Group and its agents or employees, including any firm publishing and/or distributing the finished product in whole or in part, whether on paper, television, via electronic media, or on Web sites, from any claim, damages, or liability arising from or related to the use of the said photographs / film / videotapes / electronic representations and/or sound recordings of me. I acknowledge and agree that this agreement is binding on all heirs and assigns. I acknowledge and agree that this agreement is irrevocable, worldwide and perpetual. I hereby authorise the reproduction, sale, copyright, exhibit, broadcast, electronic storage and/or distribution of said photographs / film / videotapes / electronic representations and/or sound recordings without limitation across all media and in perpetuity at the discretion of Black Sparrow Group and I specifically waive any right to any compensation I may have. In the instance I have been provided with a copy(ies) of the said photographs/film/videotapes/electronic representations and/or sound recordings I acknowledge and agree that I can only use them on my personal and/or professional website and/or personal and/or professional social media accounts. I cannot re-distribute, sell, exhibit, or broadcast the said photographs /film / videotapes / electronic representations and/or sound recordings in any other way or on any other platform. This agreement contains the entire agreement between the parties to this release and the terms of this agreement are contractual and not mere recital. Acceptance * Any signature (including any electronic symbol or process attached to, or associated with, a contract or other record and adopted by a person with the intent to sign, authenticate or accept such contract or record) hereto or to any other certificate, agreement or document related to this transaction, and any contract formation or record-keeping through electronic means shall have the same legal validity and enforceability as a manually executed signature or use of a paper-based record keeping system to the fullest extent permitted by applicable law. I agree to the terms & conditions (We respect your privacy) Thank you - we will be in touch shortly to confirm details.