For valuable consideration acknowledged as received, and by agreeing to this Photo and Release Form, I hereby grant the National Eczema Association, their representatives, employees, agents, assigns, and licensees (“NEA”) a perpetual, royalty-free, worldwide license to use all photographs, film, audio, or other recording submitted by me to NEA through its online submission process or taken of me (or my child) (“Model”) at or during the NEA-sponsored or NEA-affiliated event (e.g., Eczema Expo) and all associated parts including any descriptive text, keywords or other metadata (the “Content”) for use in any media including digital, electronic, online, print, television, film, or recording session (“Media”) for marketing, promotions, educational, research, and commercial purposes. I further agree that the Content may be combined with other images, text (including clinical descriptions for identifying types and characteristics of eczema), graphics, film, audio, and audio-visual works as NEA considers appropriate. I further agree that the Content may be altered and used to develop and improve machine learning algorithms, artificial intelligence, and other technologies by NEA. By checking the box below, I consent to my (and, if applicable, my child’s,) personal information in the Content being processed and used by NEA as described above. I understand that I have the right to withdraw my consent for the personal information processing activities contemplated under this Photo and Release Form at any time.
Furthermore, I consent that my (or my child’s) name, identity, an association with having Eczema, demographic data, or other personal information derived from the Content that represents physical, physiological or behavioral features or characteristics may be revealed therein or by descriptive text or commentary and may be used for the purposes above. I voluntarily and knowingly waive any rights, prohibition, claims or interest I may have to control the use of my (or my child’s) identity, likeness, or personal information in the Content. Notwithstanding, I understand that I have the right to withdraw my consent for the processing activities contemplated under this Photo and Release Form at any time.
I release to NEA all rights to exhibit, reproduce, promote, market, and/or sell copies of the Content in print and/or electronic form publicly and/or privately into perpetuity. I acknowledge and agree that have no further right to additional payment or other compensation; and this Photo and Release Form is binding upon my heirs and my assigns. I fully understand that I will not receive any monetary payments for my (or my child’s) participation. I hereby irrevocably waive any and all rights to seek or obtain any injunctive or other equitable relief against NEA.
I agree that this Photo and Release Form is irrevocable, worldwide and perpetual, where consistent with applicable law, and governed by the laws (excluding the law of conflicts) of Oregon (USA).
I agree that the Content, including descriptive text and keywords, may be made publicly available worldwide and may be transferred to countries with different data protection / privacy laws where it may be stored, accessed, and used, under the privacy policy of NEA’s assigns or licensees.
I understand clinical descriptions for identifying types and characteristics of Eczema may be combined with the Content, and is not intended as a diagnosis, assessment, or treatment for my (or my child’s) eczema.
NEA is a data controller and I acknowledge that its contact information was provided to me and I know how to contact them for data privacy queries, such as requesting at any time the withdrawal of my consent for the processing activities contemplated under this Photo and Release Form.
National Eczema Association
505 San Marin Drive, #B300
Novato, CA 94945
Phone:
415-499-3474 (domestic)
800-818-7546 (toll free)
Email:
info@nationaleczema.org
Privacy Notice: The processing activities contemplated by this Photo and Release Form are further described in NEA’s Privacy Policy (Privacy Policy ). Please review this Privacy Policy for a description of the purposes of processing, the categories of personal information processed, the types of third parties receiving the personal information, and your rights in regard to your personal information,
Duration of storage: I agree that, subject to applicable data protection laws, NEA, its assigns, or its licensees may store the Content, this Photo and Release Form, and associated personal information, for as long as necessary to fulfill the purposes described in this Photo and Release Form.
Sale of Personal Information: In the context of data protection laws, certain processing activities described in this Photo and Release Form may constitute the “sale” of personal information to third parties. Generally, NEA will only provide your Content, description of Content, and the details of your age or race to third parties in a de-identified manner, so that it is no longer personal information (i.e., cannot identify you). NEA may provide your name and contact information to third parties for limited purposes, such as enabling the licensing of the Content. However,
you may be contacted by third parties regarding the Content for purposes of their processing activities, which might include obtaining your direct consent for their processing activities or in the defense of legal claims.
I represent and warrant that I am at least 18 years of age and have the full legal capacity to execute this Photo and Release Form on my behalf (and/or on behalf of my child).
This agreement is optional. To decline, do not check the agreement box below.
