Consent and Release Agreement

By submitting my manuscript/s and photograph/s, hereinafter referred to as the “materials,” I agree to allow Media America, Inc. (MAI), a Tennessee corporation in the United States of America, to publish the submitted materials on the Web site copingmag.com/cwc and in Coping® With Cancer magazine; and to publish the materials in other MAI-authorized publications, products, promotional materials and electronic mediums including the Internet.

MAI may also copy and distribute, or allow to be copied and distributed, reprints of the submitted materials as published. I understand that all materials submitted to MAI are gratuitous if published, and that publication is not guaranteed.

I attest that the submitted materials do not violate any person’s or entity’s copyright, trademark, rights of publicity, right of privacy and/or any other such right. I hereby release, discharge and agree to save harmless MAI and its employees or agents, affiliates, legal representatives or assigns and all persons acting under its authority or for whom it is acting, from any liability by virtue of any publication of my likeness or other submitted materials, including, but not limited to, claims for libel or invasion of privacy, as well as any liability arising by virtue of any distortion, alteration, or optical illusion, whether intentional or otherwise, that may occur or be produced in the making of my submitted materials.

I understand that any submitted materials are subject to editing. I acknowledge the ownership of copyright rights in any “edited” version belongs to MAI as original creations of derivative works, and if I submit my submitted material for use in any other medium, I acknowledge that I do not have the right to use the “edited” version published by MAI without its permission.

I understand that MAI will make every effort to return materials to me if requested; however, I agree that MAI is not responsible for lost, stolen, damaged or unreturned materials.

I hereby warrant that I am 18 years old or older and have every right to enter into this Agreement in my own name. I state further that I have read and fully understand this Consent and Release Agreement prior to its execution. This Agreement shall be binding upon me, my heirs, legal representative, and assigns.

If applicable, as parent or guardian of a minor, I give my consent for the publication of the submitted materials that reference or show this person.