Dominique Cares: Registration Form

Contact Information

Registrant
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Are you the primary contact?
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Registrant's Role in the Family
 
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As part of this registration process, I hereby agree and consent that Dominique Cares may take images and/or audio recordings of me and my voice, and the image and/or voice of any child(ren) for whom I am the parent or guardian, and they may be used without restriction by Dominique Cares for any purpose, including public broadcast. These conditions apply to any submitted media, such as video footage, audio recordings, images, and still photographs provided by me as an on-camera participant for Dominique Cares' use. It is also understood that Dominique Cares retains exclusive, unconditional ownership of and broadcast rights to any images or sound recordings obtained by Dominique Cares. I hereby release and discharge Dominique Cares and its licensees from any claims of damage or cause of action resulting from usage of these images and/or audio recordings. I agree that the consent provided herein is irrevocable.
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