model authorization, agreement and release

In consideration of my engagement as a model and upon the terms stated hereunder, I hereby grant to Hibbett Retail, Inc., its parent, subsidiary and affiliated entities and its successors and assigns (including, but not limited to, City Gear, LLC) (collectively, “Hibbett”) the perpetual, worldwide and unrestricted right and permission to copyright, use, re-use, publish and republish images or video of me, or in which I may be included intact or in part, composite or distorted in character or for without restriction as to changes or transformations in conjunction with my own or fictitious name, or reproductions thereof in color or otherwise, made through any and all media now or hereafter known for illustration, art, promotion, advertising, trade or any other purpose whatsoever, including printed material. I agree that Hibbett is and will be the sole and exclusive owner of all right, title and interest in any works created that include images or video of me, including any and all copyrights or other intellectual property rights therein, which rights shall be transferable by Hibbett to any third party at Hibbett’s sole discretion.

Such right and permission shall be exercisable, in whole or in part, at the sole discretion of Hibbett, and I agree that Hibbett may provide such images or video to any other third party for use by that third party for any purpose whatsoever and I shall be due no consideration therefor from Hibbett or from any third party, which third party is an intended beneficiary of this release and agreement. I hereby relinquish any right that I may have to examine or approve the completed product or products or the advertising copy, printed matter, or other material of any kind that may be used in conjunction therewith or the use to which it may be applied by Hibbett or any third party.

I irrevocably waive any and all rights with respect to any images or video of me created by Hibbett or by a third party on behalf of or for Hibbett. I hereby release, discharge and agree to save harmless Hibbett and any and all third parties from any liability that by virtue of any blurring, distortion, alteration, optical illusion or use in composite form whether intentional or otherwise may occur or be produced in the taking of the finished product or in any subsequent processing or reproduction thereof, as well as any publication thereof, including without limitation any claims for libel or invasion of privacy.

I agree that I am accepting this Authorization, Agreement and Release in consideration of the opportunity to be photographed and/or videoed, and I shall not be entitled to receive any additional or different consideration unless agreed to by Hibbett in a separate signed writing. I further agree that if Hibbett elects to provide me with additional compensation in the form of either cash or product, I shall be solely responsible for any tax liability associated therewith, and Hibbett may issue an Internal Revenue Form 1099 reporting to the Internal Revenue Service the amount of compensation that I have received. If I receive compensation in the form of product, I agree that Hibbett may include the retail value of such product or products in any such reporting to the Internal Revenue Service.

I agree that this Authorization, Agreement and Release shall apply and govern with respect to any images or video taken of me by or at the direction of Hibbett as of the date referenced below and in perpetuity thereafter, unless and until I provide Hibbett with a signed withdrawal from this Authorization, Agreement and Release sent to Hibbett by U.S. Certified Mail, Return Receipt Requested, or by courier service properly addressed as:

Hibbett Retail, Inc.
2700 Milan Court
Birmingham, AL 35211
ATTN: Legal Department

I agree that if I send such signed withdrawal to Hibbett, the terms of this Authorization, Agreement and Release shall nevertheless continue to apply and govern with respect to any image or video footage created prior to the date such signed withdrawal is received by Hibbett.

I have read the above Authorization, Agreement and Release prior to its execution; I fully understand the contents thereof. This Authorization, Agreement and Release shall be binding upon me and my heirs, legal representatives and assigns.

If this Authorization, Agreement and Release pertains to a minor, I hereby certify that I am the parent and/or guardian of such infant, who is under the age of eighteen years, and in consideration of value received, the sufficiency and receipt of which are hereby acknowledged, I hereby consent that any images or video which have been or will be taken by Hibbett may be used by Hibbett for the purposes set forth herein and subject to all of the terms set forth herein.