Release Form for Media Recording

I, the undersigned, do hereby consent and agree that Hubfit Active, its employees, or agents have the right to take photographs of me on ___ / ___ / ____ to use exclusively for the purpose of Hubfit Active on their website – www.hubfitactive.com.au , Hubfit Active Social pages, marketing collateral. I further consent that my name and identity may be revealed therein or by descriptive text or commentary.

I do hereby release to Hubfit Active, its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used.

I also understand that Hubfit Active is not responsible for any expense or liability incurred as a result of my participation in this photo shoot including medical expenses due to any sickness or injury incurred as a result.

I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement. If I am under 18 yrs of age a Guardian has read the above agreement and signed as my representative.

Name: _________________________________ Date:__________________________________
Phone: _________________________________ _______________________________________
Signature: ______________________________ _______________________________________

Guardian’s Name: _______________________ Date:___________________________________
(*if participant is under 18 yrs of age)
Phone: _________________________________ _______________________________________
Signature: ______________________________ _______________________________________