Download Speaker Release Form - Technology at Pitt

 Speaker Release Form
Name of Presenter/Participant:
Mailing Address:
Email Address:
Phone Number:
Presentation
Title(s):_______________________________________________________________________
Presentation
Description(s):__________________________________________________________________
1. Subject to the distribution limitations identified in paragraph 2 below, I hereby give the University of
Pittsburgh (“University”) permission (1) to take photographs and to record the Presentation
(referenced above) in audio, audio-visual, or other media (the “Recording”); (2) to display, edit,
duplicate, and distribute my Presentation as it appears in the Recording, in perpetuity and throughout
the world in any medium now known or later developed, without any obligation to pay royalties; and
(3) to use my name, title, image, and likeness in connection with the Recording and any
accompanying materials.
2. I authorize the following distribution of my Presentation as it appears in the Recording:
____ (initial) Internal use and replay at the University, which would include allowing University to
post the Presentation/Recording as Private Content on the University’s iTunes U Site.
____ (initial) External use and replay outside the University for access by the public, which would
include allowing the University to post the Presentation/Recording as Public Content on the
University’s iTunes U Site and for any other University non-commercial research and
education activities.
____ (initial) I acknowledge that I received a copy of the iTunes U Content Services Agreement
(“iTunes U Agreement”) between the University and Apple and agree to allow my Presentation
to be posted as Public Content pursuant to the terms of the iTunes U Agreement.
3. I understand and agree that:
a. The University shall own only the copyright in the Recording, and I will continue to own
copyright to my original content within the Presentation;
b. The University shall retain a non-exclusive right to my content contained within the
Presentation;
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c. University is not responsible for any unauthorized use of my Presentation;
d. I am solely responsible for all content and material incorporated within my Presentation; I
will ensure that all third party material is covered by a permission, release, or license to
enable the Recording of my Presentation consistent with my designation of distribution
indicated in paragraph 2 above; and
e. The Presentation and Recording must be reviewed and cleared by my School or Department
Content Administrator prior to any display of the Recording.
4. I certify that:
a. I have advised my School or Department Content Administrator of all copyright clearance or
other legal issues associated with my use of third-party materials in the Presentation and I
have identified all third party materials embedded or incorporated in my Presentation on the
attached page;
b. the content contained within the Presentation is not defamatory and, to the best of my
knowledge, does not violate the rights of any third party; and
c. if the Recording will include participation by students or others, I have obtained the written
consent to the participation or a written release from the other participants who will appear in
the Recording, and these written consents/releases have been provided to my Department’s
Content Administrator.
5. Nothing in this form:
a. allows University to sell your Presentation;
b. prevents you from giving the same Presentation elsewhere; or
c. requires University to make the Recording or use the Recording as designated in Paragraph 2.
If the above terms and conditions of this Release are acceptable to you, please complete the
remainder of this form and sign and date this form.
Please complete this section to let us know about any materials that accompany or form a part of your
presentation. Examples include PowerPoint presentations, handouts, graphs, or charts. If you later become
aware of additional materials or otherwise need to amend this list, please contact University
Communications.
Presentation materials of which I am the sole copyright owner and for which I grant University
a non-exclusive license to use in connection with the Recording:
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Presentation materials of which I am NOT the sole copyright owner but have written
permission to use in the manner contemplated above in connection with the Recording:
Presentation materials of which I am NOT the sole copyright owner but have concluded fall
within the fair use principles of copyright law to the extent they are used in my Presentation:
Presentation materials of which I have not received written permission to use and of which I am
unsure of the copyright implications:
Participants in my Presentation which I have received written consent/release to their appearance
in connection with the Recording:
Participants in my Presentation which I HAVE NOT received written consent/release to their
appearance in connection with the Recording:
Signature:
Speaker Release Form
Date:
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