Teens Teach Tech - Media Release

For valuable consideration, the receipt and adequacy of which I acknowledge, I irrevocably give to Connected Nation, its legal representatives, agents, licensees, permitees, or assigns (“Connected Nation”) and AT&T Services, Inc., its parent, subsidiaries, affiliates, related companies and any of its legal representatives, agents, licensees, permitees, or assigns (“AT&T”), the perpetual, worldwide, exclusive license, right, and permission to copyright and/or trademark in the name of Connected Nation or AT&T and to use in any form or fashion, including, but not limited to, advertising, publicity and all other purposes deemed appropriate by Connected Nation or AT&T, the right to take or use photographs and/or video of me and my family, my name, signature, picture, image, likeness, voice, poses, plays, appearances, movements, or any other indicia of my identity or activity of any nature created, depicted, captured or recorded in connection with the Connected Nation’s Teens Teach Tech, powered by AT&T or Digital Skills Training programs (collectively, “Materials”) without further notification, authorization, or compensation to me or anyone acting on my behalf.

Please type in your initials in the boxes below to indicate your acceptance of the statements.

1. I authorize Connected Nation and AT&T, their assignees and transferees to use and publish the same in print and/or electronically. I understand that the Connected Nation and AT&T may use all Materials at each’s sole discretion and that I do not have any right to inspect or approve the use of the Materials in any Media. Connected Nation and AT&T each may transfer all of the rights granted by this Media Consent and Release Form.
*This question is required.

2. I further waive, assign and release to Connected Nation and AT&T all rights associated with the Materials and Connected Nation and AT&T from any liability associated with the Material or use of the Materials in any Media.
*This question is required.

3. I agree that Connected Nation and AT&T may use such photographs or videos of me and my family with or without my name for any lawful purpose, including for example such purposes as publicity, illustration, advertising and web content.
*This question is required.

4. I am over eighteen (18) years of age (nineteen in Alabama and Nebraska; twenty-one in Mississippi and Puerto Rico) and I have full legal capacity to grant this consent and release, and have read and understood the above consent and release prior to its execution.
*This question is required.

5. If I am under eighteen (18) (nineteen in Alabama and Nebraska; twenty-one in Mississippi and Puerto Rico) years of age, my parent or guardian attests that he or she has read and understands the above consent and release prior to execution, and agrees to such consent and release. This release is made on behalf of myself, my heirs, executors, administrators and assigns and is to be governed in accordance with the substantive laws of the State of Texas without regard to the state’s conflict of laws rules.
*This question is required.

6. Name (First & Last) of student participating in Teens Teach Tech. *This question is required.

7. Team Name *This question is required.

8. If signing on behalf of a minor:
I am the legal parent or guardian of the above-named minor and am authorized to grant consent and release.

*This question is required.

9. If person is a minor, please provide the name (first and last) and relationship of the person granting permission.

10. Email Address (for release confirmation and copy). This can go to your mentor's email if you would like. *This question is required.

11. By entering your name below, you agree to the use of an electronic signature granting Connected Nation and AT&T permission for the above rights. *This question is required.