Privacy

Photos

1. I, the undersigned, a participant in the production and videotaping/photographing/recording described below (or the parent, legal guardian, or person otherwise legally authorized to consent on behalf of such participant), hereby consent to the taking of any and all photographs, motion pictures, television and/or video tapes, digital video or image, voice recordings, and /or other recordings (collectively, “Recordings”) of my/his/her person at or relating to Hospital for Special Surgery (which includes any location at which it provides services as well as any office of any member of its medical staff) (collectively, the “Hospital”)) and/or any other location(s) as I and the Hospital agree during the course of my/his/her participation in (the “Production”) agree to the use of the Recordings and Production as follows: For any educational, training, contribution solicitation, marketing, publicity, promotional or other purpose, in any medium whatsoever, by the Hospital and/or by any person or persons the Hospital may name and /or for any broadcast or other public viewing. Such Recordings may be used as described above, in full or edited form, and may be incorporated into other recording or formats and may be copied for multiple distributions and/or broadcast. 2. I agree that I will receive no compensation or other remuneration for the taking, production, use, broadcast, and/or distribution of such Recordings or for my participation in any manner in such Production, and I specifically release the Hospital and all others from any liability or other obligation arising from the taking, production, use, broadcast, and/or distribution of such Recordings and from my participations in the Production. 3. I understand that I have the right to withdraw from participating in the Recordings at any time during the Production and that I have the right to revoke this consent at any time to the extent that the Hospital and/or its designee have not relied upon it, or has not submitted the Recordings and/or Production for use in external media. 4. I represent and warrant that I have all necessary rights and licenses relating to the uses consented to above for any photographs, videos and other recordings that I provide in connection with the Production.