Speaker:
Date:
Department:
Title/Description of Recording
SPEAKER’S PERMISSION FORM
Grant
I consent to the recording of my statements, image, likeness, actions, voice, conversations and material spoken or
otherwise provided by me to Yale in connection with the________________ delivered by me on ________,
201_ (collectively, the “Presentation”).
I grant to Yale University (“Yale”) the right to record my presentation and copy, reproduce, transcribe,
digitize, distribute, transmit, broadcast, exhibit, display, copyright, create derivative works of, license, transfer,
translate, edit or otherwise use such recording in whole or in part, perpetually throughout the world in all
media now existing and hereinafter developed for educational, promotional or other purposes that support
Yale’s mission, I also grant Yale the right to use my name and biographical information in connection with
the foregoing. I understand that these rights may be exercised without compensation to me.
Nothing in this Speaker’s Permission Form (the “Agreement”) grants to Yale exclusive rights to use the
material underlying the Presentation (e.g., written lecture notes or research), and I shall not be precluded by
virtue of this Agreement from exploiting publishing or other rights in such underlying material. However, I
acknowledge that I have no ownership rights in any recordings, reproductions or other derivative works of
the Presentation created by Yale. Yale agrees that it will attribute you as the source of the Presentation in
connection with all uses covered under this Agreement.
Release
I release Yale from any claims arising from the use of the Presentation including any claims that Yale has
defamed me, invaded my privacy, or infringed my moral rights, rights of publicity or copyright. I hereby waive
the right to inspect or approve any uses of the Presentation.
General
I affirm that my Presentation is my original work and that I have obtained all necessary rights, including
copyrights, to grant this permission to Yale. I have included appropriate citations to the sources of all thirdparty content. Notwithstanding the foregoing, Yale recognizes that you may in certain instances rely on fair use
in good faith in the use of third-party content. You will bring all instances of your reliance on fair use to the
attention of _______________ prior to the recording of your Presentation.
I understand and agree that Yale is not obligated to utilize the rights granted in this Agreement and all such
rights, permissions and releases herein extend and apply to Yale, its assigns, contractors, licensees,
distributors, successors, and agents.
This Agreement shall be governed by the laws of the State of Connecticut without regard to its principles of
conflicts of laws, and shall be binding on me, my heirs, assigns, licensees, and legal representatives.
I have read and understood this Agreement and I am over the age of 18. This Agreement expresses the
complete understanding of the parties.
Rev. 4-8-15 SCG
Speaker:
Department:
Title/Description of Recording
Name:
Signature:
Address:
4850-2276-5332, v. 2
Rev. 4-8-15 SCG
Date:
Date: