Fan Application and Release Agreement
Name:
Home Phone:
Home Address:
Age:
Work Phone:
Work Address:
E-mail Address:
Occupation:
Supervisor's Name:
Supervisor's Phone:
1.
Why do you want to meet Marty Stuart?
2. Why do you think
you should be chosen to meet Marty Stuart?
3.
How long have you been a fan?
4.
Do you have any collections or memorabilia
related to Marty Stuart? If so, describe:
5.
How has the music of Marty Stuart impacted your
life?
Person to be contacted in case of emergency:
Name: ____________________
Phone: ____________________
Doctor's Name: _________________ Phone:______________
Please list any allergies or medical
conditions that the producers should be aware of:
______________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
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By signing and submitting this application for consideration, I
(the "Applicant") agree to and acknowledge following terms and
conditions and to be bound by the CMT Got
Me In With the Band Rules set forth at CMT.com.
I agree that High Noon Productions, LLC. ("High Noon")
and its employees, agents and contractors (collectively, "the
Producers") have sole discretion in selecting which applicants will appear
on CMT Got Me in With The Band (the "Production"). I understand that
all selection decisions are final and nonappealable and are solely at the
Producers' discretion. I agree to accept whatever decision the Producers make.
I understand that if: 1) my submitted materials and this
application (the "Materials") are selected by the judges; 2) the
Producers determine that I meet all of the eligibility requirements and have
complied with all contest rules set forth at CMT.com, and 3) I am chosen by the
Producers to appear on the show, then:
(a) I may be given the
opportunity to meet a country music personality selected by the Producers at a
location and under conditions determined at the Producers' sole discretion (the
"Opportunity"); provided that
(b) I must be willing
to: (i) be videotaped and interviewed by, and cooperate fully with, the
Producers, (ii) execute all appropriate releases and consent forms required by
the Producers; (iii) comply with all contest rules and provisions of this
Release (and any other consent forms and releases required by Producers).
II understand that, in order to be selected for the Opportunity, I must be at least 21 years of age, and be a legal U.S. resident
I acknowledge that upon my submission of the Materials, they shall
become the sole and exclusive property of the Producers. I represent and
warrant that the Materials I am submitting are my own original work and do not
infringe on any third party's copyrighted material, trademark or other
intellectual property rights.
I also represent and warrant that, prior to submission, I am the
owner of the Materials, and that the Materials may be broadcast and otherwise
used as set forth herein without obtaining permission from or making any
payment to any third party. I agree that all persons appearing in the Materials
must sign consent forms and/or releases before they can be considered for the
Opportunity or inclusion in the Production. A parent or guardian must sign the
consent/release form for minors depicted in a submitted video. Failure to
provide, obtain and execute all additional requested releases and/or consents
will result in disqualification of the Applicant. These release and/or consent
forms will be provided by the Producers.
I understand that all materials provided to Producers by me will
not be returned to me. The Producers are not responsible for lost, damaged or
misdirected tapes under any circumstances.
I authorize the use and reproduction of all or any portion of the
Materials and the Performance (as defined below) in conjunction with CMT Got Me
in With The Band by the Producers. The Producers shall have the right to modify
and adapt the Materials for incorporation into the Production and the right to
exhibit, transmit, license, assign and/or distribute the Production in all
markets and media throughout the world, in perpetuity and shall have the right
to include all or any portion of the Material and Performance in the
advertising and promotion of the Production in all media. By submitting this
application I acknowledge that the Producers may use the Material and the
Performance in accordance with the permission granted herein without any
payment to myself or any third party.
I agree that if I am selected to appear in the Production, the
Producers may videotape and photograph me and record my voice and conversation
including quotes, paraphrases, sounds, and any performance of musical
composition(s) during and in connection with the Production (the
"Performance"). I also understand and agree that this Production is a
non-guild production and there will be no residual or any other type of payment
due in connection with my Performance.
I agree that, at no cost to Producers, I have secured, or will
secure (and/or will arrange with any respective publisher and/or third party
owner to secure) all rights, including synchronization rights necessary for you
to use any musical composition(s) contained in the Production, but only with
respect to composition(s) I own, control, wrote and/or co-wrote in connection
with the Production. Notwithstanding the foregoing, nothing in this Release
shall affect my right, or the right of any authorized publisher or co-writer,
to collect public performance royalties.
I agree that the Producers shall be the exclusive owners of all
copyright and other rights in and to such taping, photography and recording and
will be able to use them forever and throughout the world, and to license
others to use them, in any manner the Producers wish and in any and all media
now known or hereafter discovered or developed along with incidental uses in
connection with the merchandising of the Production or its related products,
but not so as to constitute an endorsement of an unrelated product of the
Production, without compensation to the Applicant. Neither Applicant, nor any
other party now or hereafter having an interest shall have any right of action
against the Producers or any other party arising out of any use of said
Materials or the Production.
I understand, that if I am selected to experience the Opportunity
and participate in the Production, the Producers' crew will come to my home or
place of work (the "Property") to videotape me without advance notice
or warning. In signing this application, I represent and warrant that I have
the right to, and hereby grant to, the Producers, and their respective parents,
subsidiaries and affiliates, licensees, successors and assigns, the right to
enter upon and film, photograph and record all or any part of the exterior and
interior and contents of the Property, including names, signs and identifying
insignia of the Property with such personnel and equipment as the Producers may
consider necessary or desirable and to perform the production and other
activities contemplated by this Release. I further represent and warrant that:
(a) I am the owner of the Property and/or have the right to permit the
activities contemplated by this Release, I have the requisite power and
authority to enter into this Release and to grant and convey to the Producers
all of the other rights set forth herein, and the permission of any other entity
or person is not required to carry out the production activities and grant of
rights set forth in this Release; or (b) if I am not the owner of the Property
and I do not have the legal right to authorize the activities contemplated by
this Release, I will secure from the appropriate party(ies) all the
permissions, rights and releases stated herein and as further requested by the
Producers. I hereby consent to the use forever and throughout the world by the
Producers, and their respective successors, licensees, nominees and assigns, of
said photographs and videotape and sound recordings in or in connection with
the production, exhibition, distribution, advertising, and exploitation and/or
other use of any of our videotapes and/or otherwise in any and all media now
known or hereafter discovered or developed.
By submitting the Materials, I agree to release, discharge, and
hold harmless the Producers, Remote Productions, Inc., CMT, CMT.com, MTV
Networks, Inc., Viacom International, Inc., Columbia Broadcasting System (CBS),
together with their respective parent, subsidiary and affiliated companies,
licensees, and assigns, and their respective officers, directors, employees,
agents and representatives from any claim or liability arising from or related
to submission of the Materials, participation in this contest, appearance in
the Performance or Production and/or acceptance or use of the Opportunity.
I agree that I shall not make any claim against Producers, Remote
Productions, Inc., CMT, CMT.com, MTV Networks, Inc., Columbia Broadcasting
System (CBS), Viacom International, Inc., and/or Program Sponsors, or any of
their parent, subsidiary, divisions, affiliated and/or related entities or
their respective officers, directors, shareholders, employees, agents, contractors,
successors, licensees and assigns, for any liability, damages or otherwise
arising out of my appearance in the Program pursuant to the permission hereby
granted. I hereby irrevocably and forever release, discharge, indemnify and
hold harmless Producers, and all related companies (including, without
limitation, MTV Networks, Viacom International and High Noon Productions LLC),
officers, board members, employees, representatives, assigns, licensees,
exhibitors, sponsors thereof, and the successors and assigns of each of them
and any participants in the Program from and against, and I hereby irrevocably
and forever waive, any and all liability, claims, demands,causes of action,
damages, injuries, costs, expenses (including, but not limited to any medical
costs and/or expenses) and any and all other liabilities of any kind or nature
that I may have against Producers or such other party(ies) claiming through me
have had, now have or hereafter will have against any or all of such
entities/persons, including but not limited to claims for defamation, violation
of my right of privacy, emotional distress, pain and suffering, any damages or
bodily injury (direct or consequential), or any other matter arising out of or
in any manner connected with this undertaking and the use and exercise of the
rights granted herein or in any way relating to my acceptance of prizes or in
connection with the Program no matter how caused. I hereby affirm that I do not
have the right to rescind, nullify or conjoin the rights granted hereunder
and/or Producers rights to exploit the Program. In the event of any dispute, I
agree that I will not seek injunctive relief against Producers, Remote
Productions, Inc., CMT, CMT.com, MTV Networks, Inc., CBS, Viacom International,
and/or Program Sponsors, or any of their parent, subsidiary, divisions,
affiliated and/or related entities or their respective officers, directors,
shareholders, employees, agents, contractors, successors, licensees and
assigns.
I will indemnify and hold harmless the Producers, Remote
Productions, Inc., CMT, CMT.com, MTV Networks, CBS, Viacom International,
and/or Program Sponsors, or any of their parent, subsidiary, divisions,
affiliated and/or related entities ortheir respective officers, directors,
shareholders, employees, agents, contractors, successors, licensees and assigns
from and against any and all liability for any and all claims, demands,
damages, costs or judgments brought on behalf of any third party arising from
or out of: (a) personal injuries, death or property damage suffered by such
person or persons resulting directly or indirectly from any act or omission on
my part in connection with the Producers' use of the Materials and/or the
Performance and/or the activities conducted at the Property; and/or (b) Applicant's
breach of the representations and warranties set forth in this Release.
I agree to work with and cooperate with Producers and the
production team behind-the-scenes at a concert, recording session, video shoot
or as otherwise requested by the Producers until the Production and related
work is completed. I also agree to return as requested by the Producers to
assist in any postproduction and editing needs (including, but not limited to,
reshooting and voiceovers).
I will abide by all the rules and regulations prescribed by
Producers in connection with the Production and cooperate in all pre-appearance
requirements deemed necessary by Producers, and follow Producers directions
regarding my qualifications for an appearance in the Production. I will not
reveal the results of my appearance on the Program until the actual telecast of
the episode of Production in which I appear, nor will I reveal at any time the
terms of this and/or any other agreement with respect to this Production.
I agree that the Producers are not required to use or incorporate
in the Production any of the Materials or the Performance and that the
Producers may, at any time, decide not to use or discontinue use of the
Materials or the Performance.
I agree that I will be responsible for all applicable federal,
state and local taxes, if any, associated with the Opportunity and my
appearance in the Production.
I agree to comply with all of the contest rules and eligibility
requirements found at CMT.com.
I agree to leave home or work on a moment's notice to meet the
country music personality selected by the Producers and to appear on CMT Got Me
in With The Band.
I understand I will not be paid for participating in the
Production or the Materials, nor will I be compensated for lost income resulting
from or expenses incurred through my participation.
I understand that if I am selected but not available on the day of
the taping, the Producers will select another applicant.
This Release is governed by New York law without regard to its
choice of law principles. Applicant and the Producers submit to the
jurisdiction of New York courts regarding any disputes concerning this
Agreement and/or my appearance in the Production.
I agree that this statement cannot be modified or terminated
except in writing signed by the Applicant and the Producers.
In signing this application, I acknowledge my understanding and
acceptance of the above terms and conditions:
THIS IS A BINDING LEGAL DOCUMENT
_______________________________
Applicant
Print Full Legal Name
_______________________________
Signature
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Date