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Video & Photograph Release Form


By signing this form I hereby grant permission to IGNITE WORLDWIDE LLC DBA 'Ignite Self-Mastery' & Co-Hosts, its subsidiaries, legal representatives, agents, assigns, facilitators, and successors, the following:

1. The unrestricted use of my images, videos, name, likeness, or voice (herein “IMAGE”), in part or in whole, including but not limited to:

Photographs, video, and sound recording, and to use such IMAGE in any and all media, now known or which may be developed in the future, including but not limited to, cable and broadcast, television and internet, website, advertising, marketing, promotion, communications, meetings, educational conferences, brochures and other print (herein “MEDIA”).

2. The unrestricted use of my IMAGE shall continue in perpetuity but may be revoked upon written request. Upon revocation, the IMAGE shall not be used in any MEDIA not scheduled or printed at the time of revocation.

3. All rights, title, and interest that I may have in all finished photography/pictures, negatives, reproductions, and copies of the original print, and I further grant IGNITE WORLDWIDE LLC & Co-Hosts, the right to sell, transfer, and exhibit the print in copies, or facsimiles, or other, for MEDIA, as it deems fit.


4. On behalf of myself, I relinquish any right to examine or approve the finished photographs, audio, video, multimedia, or advertising recordings and copy or printed matter or computer generated scanned image and/or other electronic media that may be used in conjunction therewith or to approve the eventual use to which it might be applied.

5. I acknowledge that once IMAGE(s) is/are placed on the internet, IGNITE WORLDWIDE LLC & Co-Hosts, have no control over who can view such images and what application viewers may make of the images or how long such IMAGE(s) may remain available on the internet.


6. I hereby expressly release IGNITE WORLDWIDE LLC & Co-Hosts, its agents, employees, licensees and assigns from and against any and all claims which I have or may have for invasion of privacy, defamation, or any other cause of action arising out of production, distribution, broadcast or exhibition of the Video.


7. If I do feel there has been a violation of this Waiver and Release, I agree to mediate any claim before filing any formal action.


8. I am over the age of eighteen (18) years and acknowledge that I have read the foregoing and understand the contents.

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I desire to participate in an interactive experience (the “Event”) conducted by IGNITE WORLDWIDE LLC (the “Company”). In exchange for the opportunity to participate in the Event Services, and other good and valuable consideration, the receipt of which is hereby acknowledged, I, and my heirs, estate, insurers, successors, and assigns, agree and state as follows:


1. Participation.


  • I am a willing Participant in the Event Services and agree to abide by all rules and directions for the Event Services. I understand that I am free to leave the Event or refuse to participate in all or any portion of the Event.

  • When I attend an event or participate in any ceremonies, I will act kindly to all participants and personnel.

  • I agree not to record or photograph the Event.

  • If I become ill, involved in an accident, or injured during my participation in the Event, I will promptly report such illness, accident, or injury to a Company representative.

  • If I am being disruptive, I may be asked to leave.

  • If I have an objection to participating in the Event due to the attendance of another participant, I shall promptly disclose and explain my objection to the Company and the host of the Event.

2. Assumption of Risk.

  • I understand that my own actions, inactions, or negligence or the actions, inactions, or negligence of others or the condition of the facilities, products, or equipment, may be hazardous to me or my property.

  • I understand that the host and/or the Company are not responsible for the actions of other participants. Notwithstanding anything to the contrary set forth herein, the Company does not conduct background checks on participants who attend an Event.

  • The Company also does not inquire into the backgrounds of its participants or attempt to verify the statements of its participants.

  • The Company makes no representation or warranties as to the conduct of the participants or their compatibility with any current or future participants.

  • I understand that I am responsible for my own safety when attending an Event or meeting with another Event attendee.

  • I warrant that I am physically and mentally able to fully participate in the Event which does involve some physical activity.

  • I consent to treatment in the event of an emergency or other incident in which, in the reasonable judgment of the host of the event, I require medical care I further agree to pay all costs associated with such medical care and to indemnify and hold harmless the Released Parties (defined below) from any costs or claims arising from or relating to such medical care.

3. Release from Liability and Covenant Not to Sue.

  • I fully and forever release and discharge the Company and its respective parent, subsidiaries, clients, participants, affiliates, members, consultants, employees, agents, and insurers (each, a “Released Party”, and collectively, “Released Parties”) from any and all injuries, including, but not limited to, death, losses, damages, claims, emotional distress (including negligence or harassment claims), demands, lawsuits, expenses, and any other liability of any kind (collectively, “Claims”), of or to me, my property, or any other person, directly or indirectly arising out of or in connection with my participation in the Event Services, even if it is due to the negligence, injudicious act, omission, or another fault of a Released Party.

  • I covenant not to make or bring any such claim against the Company or any other Released Party and forever release and discharge the Company and all other Released Parties from liability under any Claims.

4. Image/Video Release.

  • I understand that in connection with my participation at the event, I may have the option to participate in an audio or video/photo testimonial or other recordings. If I choose to participate in such, I authorize the Company to capture or record my image, likeness, and/or voice in digital, audio, still, or motion picture format.

  • I assign to Company all rights to own, use, reproduce, edit, publish or post any such image, likeness, voice, or video in any medium whatsoever in its sole discretion, and for any purpose, and release Company from any and all liability in connection with such use, editing, reproduction, publication or posting.

5. Eligibility and Participant Information.

  • I hereby represent and warrant to the Company that I have never been convicted of or pled no contest or guilty to a sex crime, or any crime involving violence, and that I am not currently registered, or required to register, as a sex offender with any government entity.

  • I understand and agree that I may not attend an Event if the foregoing representation is no longer true or is false in any way and I may be asked to leave an Event or be prohibited from using the Services if the Company becomes aware of any such conviction, plea or registration as a sex offender.

  • Furthermore, if I have previously been banned from attending an Event or similar service from a third party I may be prohibited from participating in an Event.

  • I consent to you sharing my contact information with other participants as reasonably necessary.

  • I understand that the Company reserves its right to perform criminal background checks or other screenings (such as sex offender registry searches) at any time but is under no obligation to do so.

6. Indemnification.

  • I indemnify, defend, and hold harmless the Company and the other Released Parties from any and all losses, expenses, damages, and costs, including but not limited to, reasonable attorneys’ fees, arising from or relating to any third party claim related to my participation in the Event Services, including but not limited to my breach of any provision of this Agreement.

  • I shall use my best efforts to cooperate in the defense of any claim. I acknowledge that the Company reserves the right, at its own expense, to employ separate counsel and assume the exclusive defense and control of any matter otherwise subject to indemnification under this Agreement.

7. Ownership of Products.

  • I understand that all products, intellectual property, or other information I use or receive during the Event Services are and remain the property of the Company before, during, and after the event. I have no right to reproduce a similar class or event.

8. Confidentiality.

  • I understand that I may be exposed to information about the Company, the Event Services, and other participants, including, without limitation trade secrets, ideas, scripts, exercises, and other intellectual property rights (collectively, the “Confidential Information”).

  • I agree to refrain from disclosing or using Confidential Information for any purpose other than participating in the Event Services. This obligation shall survive termination of this Agreement.


9. Choice of Law.

  • This Agreement and all matters arising out of or relating to this Agreement are governed by and construed in accordance with the laws of the State of New York without giving effect to the conflict of laws provisions thereof.


10. Miscellaneous.

  • If any provision of this Agreement is illegal or unenforceable under applicable law, the remainder of the provision will be amended to achieve as closely as possible the effect of the original term, and all other provisions of this agreement will continue in full force and effect.

  • This Agreement supersedes any oral or written statements made by or to me in connection with the Event Services. This Agreement may not be modified except by a written agreement that specifically refers to the provision or provisions to be amended and that is signed by an authorized representative of the Company.

11. Informed Consent.

  • By accepting herein, I hereby certify that I:

    • am at least 21 years of age;  

    • have read and fully understand the above information;  

    • will not provide false or misleading information; and

    • voluntarily agree to participate in the Event Services, in good faith and to the best of my ability.

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