Photo Release Form - Adult


Benihana, Inc. desires now or in the future to photograph, videotape, or otherwise record my name, alias, nickname, fictional or stage name, voice, likeness, reputation, and any pictures, portraits, or photographs of me or in which I may be included, in whole or in part (hereinafter the “Images”), for any purpose including, without limitation, advertising, trade, training, educational, commercial, and/or any other lawful purpose, in any manner or form without restriction, in all media now known or hereinafter discovered, including, without limitation, print, film, videotape, DVD, the Internet, or CD-Rom (hereinafter “Works”).

I hereby grant Benihana, its parent company, affiliates, and agents and their respective officers, directors, employees and shareholders (collectively, hereinafter “Benihana”), an absolute, irrevocable, perpetual and royalty-free right to record, use, copy, modify, reproduce, sell, duplicate, edit, display, transmit, distribute, disseminate, publish and otherwise make use of the Images in the Works. By this license, Benihana will also have the right to incorporate and store, in whole or in part, any of the Images into a computer database for further and continued exploitation and to seek copyright registration for the Images or the Works, and/or any derivative works created therefrom.

I knowingly and voluntarily waive any right I may have to inspect or approve your uses of the Images, Works, or any written copy, finished photographs, or printed matter that may be created and appear in connection therewith.

I hereby release, discharge, and hold Benihana, its agents, officers, successor and assigns harmless from any and all claims I might have against you relating to the Images and/or Works including, without limitation, defamation, violation of any moral or artist rights, copyright, and/or any right of privacy or publicity.

I understand and agree that Benihana shall retain all right, title and interest in the original Works, as well as any modification, derivative works or improvements made to the Works by Benihana. I shall take no action to challenge or object to the validity of such rights, your ownership, or your ability to register your rights therein with the appropriate authorities.

I further acknowledge that I will receive no further compensation from you other than any goodwill and publicity that I may receive relating to the publication, distribution or use of the Images and/or Works.


FOR ADULTS OVER 18 YEARS OF AGE:

I warrant and represent that I am over the age of eighteen (18) and I can legally enter into this agreement. I have the capacity to sign and be bound by the terms of this Photography Permission and Release and represent that I understand the contents of this Photography Permission and Release before I affixed my signature below.

 

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DATE OF BIRTH:

DATE:

 

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Signature Certificate
Document name: Photo Release Form - Adult
lock iconUnique Document ID: f68dbb3262dc01abea5643b455c424d113bcfbeb
Timestamp Audit
May 8, 2025 10:55 am EDTPhoto Release Form - Adult Uploaded by Lauren Hall - [email protected] IP 86.1.207.42
May 8, 2025 11:02 am EDTLauren Hall - [email protected] added by Lauren Hall - [email protected] as a CC'd Recipient Ip: 86.1.207.42
May 8, 2025 11:02 am EDTZack Preschel - [email protected] added by Lauren Hall - [email protected] as a CC'd Recipient Ip: 86.1.207.42
May 8, 2025 11:02 am EDTSocial Media - [email protected] added by Lauren Hall - [email protected] as a CC'd Recipient Ip: 86.1.207.42
May 8, 2025 11:02 am EDTBailey Booher - [email protected] added by Lauren Hall - [email protected] as a CC'd Recipient Ip: 86.1.207.42
May 8, 2025 11:02 am EDTMaggie ORear - [email protected] added by Lauren Hall - [email protected] as a CC'd Recipient Ip: 86.1.207.42
May 8, 2025 11:02 am EDTYania Yanez - [email protected] added by Lauren Hall - [email protected] as a CC'd Recipient Ip: 86.1.207.42