Photo /Video/Audio Recording Consent and Release Notice

I, on behalf of myself, or if the Subject is a minor, on behalf of my minor child, acknowledge that when I purchase or accept tickets for, or agree to attend or participate in, any event or class hosted/facilitated on-premises at Funky Dog Theatrical Inc., a.k.a Funky Dog Improv, 587 W. Eau Gallie Blvd #101, Melbourne, FL 32935, and/or any event or class hosted/facilitated by Funky Dog Theatrical Inc., a.k.a Funky Dog Improv, off premises, or I contract with Funky Dog Theatrical Inc., a.k.a Funky Dog Improv, in any way I hereby give my consent to Funky Dog Theatrical Inc., a.k.a Funky Dog Improv:

a.) to record my likeness and voice on a video, audio, photographic, digital, electronic, or any other medium and to use my name in connection with these recordings; and

b.) to use, reproduce, exhibit, or distribute these recordings in whole or in part in perpetuity in any and all media throughout the universe (including but not limited to print publications, videotapes, non-theatrical, home video, CD-ROM, internet, and any other electronic or another medium presently in existence or invented in the future) for any purpose that Funky Dog Theatrical Inc., a.k.a Funky Dog Improv, and those acting pursuant to its authority, deem appropriate, including promotional, recruiting, advertising and any commercial or non-commercial use.

I hereby release Funky Dog Theatrical Inc., a.k.a Funky Dog Improv, from and against any and all claims, demands, actions, causes of actions, suits, costs, expenses, liabilities, and damages whatsoever that I may hereafter have from liability for any violation of any personal or proprietary right I may have in connection with such use of my likeness, voice, or name in any medium.
OR on behalf of the Subject if the Subject is a minor child. I have read and understand the content of this form and acknowledge this release shall be binding upon the Subject, his heirs, legal representatives, and assigns, and the individual (including the individual’s heirs, legal representatives, and assigns) executing this form in those circumstances where the Subject is a minor child.