In consideration of my opportunity to be included in media produced and/or published by the Colorectal Cancer Alliance (Alliance), I grant the Alliance and its successors, licensees and assigns, unlimited rights to the video and photos I submit through this form (Material). These rights include the right, but not the obligation, to use, modify, and publish this Material in any markets and media (whether now known or hereafter developed), throughout the universe, in perpetuity. 

I warrant and represent that I have the right to grant all rights granted herein and that the Alliance’s use of the Material as permitted herein will not infringe on the rights of any third party. I will indemnify and hold the Alliance and its successors, licensees and assigns, harmless from and against any and all claims, damages, liabilities, costs and expenses arising out of any breach of the foregoing warranty and/or any use of the Material. I further understand and agree that (a) I shall have no right to inspect or approve any portion of the Alliance’s resulting productions and/or media, (b) I shall not be entitled to any compensation or credit by virtue of this release and (c) in no event shall I have the right to seek or obtain injunctive or other equitable relief in connection with the Material or the development, production, distribution or exploitation of any future Alliance media that includes the Material. 

By typing my name below and submitting this form, I attest that I am over the age of eighteen, of sound mind, and have read, understood and agree to these terms. Note: Once you hit submit, it should take a minute or two for your Material to upload because of the large file size. When you have successfully uploaded your Material and submitted this form, you will see a message from us in your browser and will also receive an email confirmation.