I, ____________________________, am a participant in the Vietnam Veterans' Documentary Project sponsored by Florida Veterans Programs & Projects, Inc, (FVPPI) a Not For Profit Corp. in conjunction with Flagler College, St. Augustine, FL. The purpose of the Vietnam Veterans Documentary Project is to remember and honor Vietnam veterans living in Florida by audio & or video recording their service related stories and experiences. Another purpose is to share these experiences with such educational institutions as schools and libraries and possibly with educational and commercial television program developers.

I hereby give FL Veterans Programs & Projects, Inc. and Flagler College, St. Augustine, FL and its assignees and/or designees including but not limited to the Vietnam Veterans Documentary Project, ownership of the personal & physical property (audio and/or video recordings) as herein set forth, delivered to FVPPI or to its assignees and/or designees as part of the Vietnam Veterans Documentary Project and I hereby give FVPPI and its assignees and/ or designees the right to use the property that is the product of my participation (for example, my interview, its recordings and my performance) in any manner that they deem appropriate.

I also grant FVPPI and its assignees and/ or its designees my absolute and irrevocable consent for any video recording or other photographic material or documents provided by me or taken in the course of my participation in the Vietnam Veterans Documentary Project to be used, published, and copied by FVPPI and its assignees and/or its designees in any medium.

I hereby waive any financial interest in the work product and any compensation that I may be entitled to.

I agree that FVPPI and its assignees and/or its designees may use my name, video or photographic image or likeness, statements, performance, and voice reproduction, or other sound effects without further approval on my part. I also agree that FVPPI may license or convey to third parties the recorded interview, any transcript thereof, video recording or photographic material or documents provided by me.

I release FVPPI, and all its assignees and designees, from any and all claims and demands arising out of or in connection with the use of such video recordings, photographs and documents, including but not limited to, any claims for defamation, invasion of privacy, or right of publicity. I further agree to indemnify and hold harmless FVPPI for any costs and liabilities it may incur as a result of my participation in the Vietnam Veterans Documentary Project including my participation in an audio and/or video recording.

ACCEPTED AND AGREED

Signature _______________________________ Date _________________

Printed Name __________________________________________________

Address ______________________________________________________

City ______________________ State ______________ Zip ____________

Telephone (_____) _____________________