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Release Form: I hereby grant to The Upstate Dream Institute ("UDI"), its successors and assigns, for good and valuable consideration, the absolute and irrevocable right and license with respect to my name and the testimonial made by me (the "Submitted Information") and submitted to www.dreamboost.com: (a) To use, publish and distribute my name and the Submitted Information, or any part thereof, or as amended or modified by UDI, in any and all media now known or hereafter developed, published by or under UDI authority, in whole or in part, individually or in conjunction with other testimonials and for any purpose whatsoever, including without limitation illustration, promotion, advertising and publicity. I acknowledge that UDI may use the Submitted Information in accordance with the permission granted herein without any payment to the undersigned or any third party. I represent and warrant that I am the sole proprietor of all rights in and to the Submitted Information, that I have full power and authority to grant the rights granted to UDI herein; that, if applicable, I have obtained all rights, consents and permissions necessary to grant the rights granted herein; that the use of the Submitted Information by UDI as set forth above shall not violate or infringe upon the rights of any individual or entity; and that the Submitted Information is original. I consent to any interview(s) requested by UDI and promise to speak truthfully to the representatives of The Upstate Dream Institute, consent to the utilization by The Upstate Dream Institute and its affiliates of all or any part of the information obtained through such interviews, as set forth above, agree that an interview featuring me, or any other work similar to that covered by this agreement, has not been previously published in any form or media and will not be published elsewhere in any form or media before my information is published by The Upstate Dream Institute I release, discharge and hold harmless The Upstate Dream Institute (and those acting under its permission or authority) from any and all claims, demands or liabilities arising out of or in connection with the use, production or reproduction of the testimonial and including without limitation any claims for invasion of privacy or publicity. I also acknowledge that The Upstate Dream Institute has not promised, and that I have not requested, any compensation, and that no compensation will be paid, for my participation.
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