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摄影与视频拍摄同意书
Photography / Video
Consent and Release Form
OM SPACE ACADEMY
Photography / Video Consent and Release Form
"
*
" indicates required fields
全名 Full Name per IC / ID
*
First
电话号码 Phone Number
*
身份证号码 IC / ID No.
*
年龄
*
18岁以上 Above age of 18
18岁以下 Under age of 18
同意书 Consent and Release Form
*
Consent and Release Form
I, hereby grant permission and authorization to Om Space Sdn. Bhd. (“hereinafter referred as “Om Space”) the rights and permissions to publish, reproduce or otherwise use of my photos, images, videos, recordings and/or any audio-visual recordings without payment of consideration to me (“the Materials”).
I acknowledge and understand the Materials may be used for commercial and/or non-commercial purposes including but not limited to education, training and consultation activities, marketing and promotion of the course, program, therapy and consultation practice.
I understand that the Materials may be edited, copied, exhibited, published and/or distributed. I also understand the Materials may be used individually or in conjunction with other media in any medium, including without limitation to print publications, digital publications, and/or public broadcast for any lawful purpose within the nature of business of Om Space. There is no time limit on the validity of this release nor are there any geographic limitations on where the Materials may be distributed.
I hereby agree and grant Om Space including its employees, agents, licensees, successors, and/or any third-party organizations all ownership rights and irrevocable right and permission to use, publish, sell, distribute, and/or promote the Materials.
I understand that my participation is voluntary and that I may, at any time, discontinue my involvement before signing this document subject to the Om Space’s Return and Refund Policy.
I understand that I shall take full responsibility for my subscription and/or participation in any of the course, workshop and/or therapy session(s) and the risks that it may entail (be that legal, physical, or mental) and release Om Space from any claims, demands, losses, damages, suits, and liabilities of any kind whatsoever in connection with the foregoing.
I hereby certify that I am above eighteen (18) years of age and am competent to contract in my own name in so far as the above is concerned. If I am below eighteen (18) years old, my parents or legal guardians have read this document and have given their consent by signing below.
By signing this form, I acknowledge that I have completely read and fully understand the above Consent and Release Form and are agreeable to be bound thereby. I hereby release and waive any and all claims against any person or organization utilizing the Materials for marketing, educational, promotional, and/or any other lawful purpose whatsoever.
是,我同意 / Yes, I Agree.
签名 Signature
*
家长/监护人 签名(若学生/客户是18岁以下)
Parents / Legal Guardians' Signature (if student/client is under the age of 18)
家长/监护人 姓名
Parents / Legal Guardians' Name
家长/监护人 身份证号码
Parents / Legal Guardians' IC/ID Number
家长/监护人 电话号码
Parents / Legal Guardians' Phone Number
Submission Date
Name
This field is for validation purposes and should be left unchanged.
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