MEDIA AUTHORIZATION AND TALENT RELEASE FORM

1.      I,    ___________________________________________, with full knowledge of my rights, do hereby grant Silicon Valley African Productions of San Jose, California, any successors, assignees, licensees and any other designees, forever, the absolute right and permission to broadcast and rebroadcast on television and/or radio; publish and republish in any publication, any sound recording of my voice, any photographs, motion picture film or videotape, literary, or multimedia material of my person or my legal minor(s) person in whole or in part.

2.      I affirmatively release and discharge Silicon Valley African Productions, its successors, assignees, licensees or any other designees, from responsibility for any distortion or manipulation, whether intentional or otherwise, of media materials mentioned in paragraph 1. above

3.      I understand by signing this media authorization and release form, I waive any right to inspect or approve any of the media materials mentioned in paragraph 1. above.

4.      I hereby waive any right to compensation of any kind, type or nature whatsoever, now and/or in the future.

5.      I hereby represent and warrant that I am of full age and have every right to contract in my own name or my legal minor(s) name in the above regard and I state further that I have read the above authorization and release prior to it's execution, and that I am fully familiar with the content thereof.

Participant’s Signature          ________________________            Date______________________

If Participant is under the age of 18:

Name of Parent/Legal Guardian: _____________________Relationship to Minor ___________ 

Parent/Legal Guardian’s Address: _________________________________________________

Signature:    ________________________________________   Date:        ______________________