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Consent & Release for Testimonial

In Consideration of the possibility of appearing in an advertising campaign and in conjunction with my delivery of a testimonial and other commentary (collectively, "Testimonial") regarding Coloplast Canada Corporation ("Coloplast") and/or the products produced or supplied by Coloplast or its parent and/or affiliates (collectively, "Affiliates") I hereby agree as follows:

    1. I represent and warrant that the Testimonial given is original and does not infringe upon the copyright or other proprietary rights of any third party.

    2. I hereby give Coloplast and its Affiliates my consent to use, edit, abridge, supplement(including, without limitation, by way of adding subtitles and/or narration), adapt, translate, publish, broadcast and distribute all written records, audio and video recordings, photographs, quotes and all other similar records comprising or directly relating to the Testimonial (collectively, “Records”) by Coloplast and its Affiliates in connection with their respective businesses, both in and outside Canada, including on the Internet, and other similar purposes, without limitation. Further, I hereby consent to the use and release of Records by Coloplast (and its Affiliates), without limitation, to third parties in connection with (a) stories about Coloplast and/or its Affiliates in the press (in print, on television or otherwise), (b) research projects, (c) studies being published in scientific journals, and (d)other similar situations.

    3. I acknowledge and understand that Coloplast has unfettered discretion in terms of whether or not to use the Testimonial and/or Records.

    4. I agree that Coloplast will exclusively own all rights to the Testimonial and Records and hereby unconditionally assign any and all rights I may have in the foregoing. I hereby waive any and all moral rights that I may have anywhere in the world in regards of the Records.

    5. I hereby waive any right, claim, or interest I may have to control the use of my identity, likeness, voice, testimonials and quotes in the Records and agree that the uses described herein may be made without compensation to me.

    6. I release and discharge Coloplast and its Affiliates, and their respective officers, directors, employees, agents, suppliers, service providers and assigns, from any and all claims and demands arising out of or in connection with this consent and release, including, without limitation, any and all claims for libel, invasion of privacy, intrusion upon seclusion, violation of personality rights, violation of publicity rights, loss of reputation or portrayalin false light.
    7. This consent and release is irrevocable and will also bind my heirs, legal representatives, administrators, agents and assigns. Any amendment to this consent and release and any waiver of rights or benefits provided in or arising from this consent and release will only be binding and enforceable if signed by both Coloplast and me.

    8. I represent that I am of legal age in my province or territory of residence, have read and understand the forgoing statement, and am competent and have capacity to sign this consent and release.

 

This consent and release is governed by the laws of the province of Ontario, Canada (excluding its body of law regarding conflicts of law) and the Federal laws of Canada that apply in the province of Ontario. Any dispute in regards to the Testimonial, Records or the subject matter of this consent and release will be brought before the courts of the province of Ontario, Canada located in the city of Toronto.

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