Photograph and Video License and Release

Rightsholder:

For good and valuable consideration, I grant permission to the American Academy of Pediatrics (AAP) to use, modify, reproduce, distribute, and permit other persons to so use, the photographs described above (“Photo Description”), in either original, altered or derivative form (collectively, "Photos") in the work named above (“Work”). I agree that the AAP shall also be entitled to identify me, as applicable, in connection with the Photos and Work.

Release of Liability 

I hereby waive any right to compensation for such uses as described above or to inspect or approve of any uses of the Photos. I hereby release, indemnify and agree to hold harmless the American Academy of Pediatrics and its officers, agents, employees, successors, and assigns from and against all claims of liability with respect to the showing, use, or dissemination of the Photos or otherwise resulting from the activities authorized by this document. These include any claims for libel, invasion of privacy, breach of any privacy law (including the Health Insurance Portability and Accountability Act), copyright infringement, violation of a right of publicity, or false or misleading advertising.

I warrant that I have full rights to grant this permission to reproduce the Photos by virtue of creation or contract and have obtained releases from any other people in the photo.

This document shall be binding upon me, and upon my heirs, legal representatives, and assigns.

Rightsholder's signature: *
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