LXTV Appearance Release Form

APPEARANCE RELEASE FORM & ARBITRATION PROVISION
THIS IS A LEGAL DOCUMENT AFFECTING YOUR RIGHTS AND RESPONSIBILITIES
PLEASE READ IT CAREFULLY BEFORE SIGNING

I hereby irrevocably grant to LXTV, 2011 NBCUniversal Media, LLC and their parents, subsidiaries, affiliates, successors, assigns, licensees, sponsors and partners (collectively, “Producer”) the right to take motion and still pictures of me and to record my voice and any sounds made by me, including the right to use video and sound recording equipment that I did not and/or do not know about, and to obtain other information about me (collectively, the “Materials”) and to use the Materials in connection with the development, distribution and/or exploitation of the television program currently entitled “_____________” or in any other production (collectively, the “Program”), and in advertisements and promotions, throughout the universe at any time, in perpetuity, in any and all media now known and hereafter devised, without any compensation to me whatsoever. 

I represent and warrant that I am not, and during six months from today do not intend to be, a candidate for any public office.

I understand that in the course of my participation in the Program private and/or embarrassing information about me could be revealed. 

I also agree that I will not sue the Producer and will hold the Producer harmless of any potential claims arising from the creation and broadcast of the Materials, on any legal theory whatsoever, including, but not limited to, personal injury, right of publicity and privacy and defamation.  I grant these rights in consideration for my desire to participate in the Program and understand that the Producer has no obligation to use the Materials.

MEDIATION & ARBITRATION.  The parties agree that if any controversy or claim arising out of or relating to this Agreement cannot be settled through direct discussions, they shall endeavor first to settle the controversy or claim by a mediation administered by JAMS under its applicable rules.  IF THE CONTROVERSY OR CLAIM IS NOT OTHERWISE RESOLVED THROUGH DIRECT DISCUSSIONS OR MEDIATION, THE PARTIES AGREE THAT IT SHALL THEN BE RESOLVED BY FINAL AND BINDING ARBITRATION ADMINISTERED BY JAMS IN ACCORDANCE WITH ITS STREAMLINED ARBITRATION RULES AND PROCEDURES OR SUBSEQUENT VERSIONS THEREOF (THE “JAMS RULES”).  THE JAMS RULES FOR SELECTION OF AN ARBITRATOR SHALL BE FOLLOWED, EXCEPT THAT THE ARBITRATOR SHALL BE AN ARBITRATOR EXPERIENCED IN THE ENTERTAINMENT INDUSTRY AND LICENSED TO PRACTICE LAW IN NEW YORK.  ALL PROCEEDINGS BROUGHT PURSUANT TO THIS PARAGRAPH WILL BE CONDUCTED IN THE COUNTY OF NEW YORK.  THE PARTIES AGREE THAT THE REMEDY FOR ANY CLAIM BROUGHT PURSUANT TO THIS AGREEMENT SHALL BE LIMITED TO ACTUAL DAMAGES, AND IN NO EVENT SHALL ANY PARTY BE ENTITLED TO RECOVER PUNITIVE OR EXEMPLARY DAMAGES OR TO RESCIND THIS AGREEMENT OR SEEK INJUNCTIVE OR ANY OTHER EQUITABLE RELIEF.

This is the complete and binding agreement between Producer and me, and it supersedes all prior understandings and communications, both oral and written, with respect to its subject matter.  The illegality, invalidity or unenforceability of any provision of this Agreement shall in no way affect the validity or enforceability of any of the remainder of this Agreement, which shall be enforced to the maximum extent permitted by law.  This Agreement cannot be terminated, rescinded or amended, except by a written agreement signed by both Producer and me.  I also agree that if at any time I decide to stop participating in the production, Producer may use and/or re-use the material that has been recorded on the premises up to the time I tell the Producer about my decision.  This Agreement shall be interpreted under the internal, substantive laws of the State of New York without regard to the conflicts of law provisions thereof.


Signature: ________________________ Date: _____________


D.O.B. ___/___/___*  Phone: _________________


Print Name: _______________________________


Address:____________________________________________


If participant under eighteen years of age or older:


Signature of Parent/Guardian: ___________________________


Date: ____________


Phone:___________


Print Name: _________________________________


Address:_____________________________________________


* For verification purposes only pursuant to 18 U.S.C. §§ 2256 et seq.
Est. 7/14/09