Electronic Release Form
I, the undersigned, affirming that I am 18 years of age or older, hereby and irrevocably grant The Broad Institute, Inc. (“BROAD”) located at 415 Main Street, Cambridge MA 02142, the right to:

(1) Photograph, film and record my likeness, appearance, voice, participation, and performance on photographic or digital film, videotape, audio tape or other medium (collectively “RECORDINGS”) to be used in or for BROAD written, electronic, and web publications (“PURPOSE”);

(2) Reproduce and publicly distribute, display and perform, in print, electronic or other medium, copies of the RECORDINGS, in whole or in part; and

(3) Use my name and biographical information in connection with the RECORDINGS only for the PURPOSE.

I further acknowledge that I will not receive any compensation related to the RECORDINGS or this agreement and that BROAD exclusively owns all rights to the RECORDINGS, and to any derivative works created therefrom. 

I represent that I possess all rights necessary to grant this release and that I have entered into this agreement voluntarily.

I expressly release and hold harmless BROAD, its directors, officers, employees, affiliated investigators and agents from any claim, liability, damage, loss or expense incurred by me, my agents, heirs or assigns arising from the RECORDINGS.

This agreement expresses the complete understanding of the parties and shall be governed in accordance with the laws of the Commonwealth of Massachusetts. 

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