Goodwill Media Release

MEDIA RELEASE AND AUTHORIZATION FORM  WITH PROTECTED HEALTH INFORMATION (PHI)

To fulfill our mission, we believe in sharing our story—and at times, you may play a meaningful role in that process.

Goodwill Industries of the Greater Chattanooga Area (“Goodwill”) regularly creates and publishes media content to promote its mission, programs, services, and events. This may include photographs, video/audio recordings, interviews, and written testimonials.

I hereby grant Goodwill, its agents, employees, affiliates, successors, assigns, and affiliated partners (collectively, “Representatives”) the unrestricted right and permission to copyright, publish, use, reproduce, edit, exhibit, broadcast, or distribute the Media Content, as defined below, in perpetuity in 

any format or medium, including, but not limited to, publications, websites, social media platforms, press releases, promotional materials, internal communications, presentations, or reports, in perpetuity throughout the universe, in any medium or format whatsoever now existing or hereafter created without further consent from or royalty, payment, or other compensation to me. Further, I hereby relinquish, 

give, transfer, and assign to Goodwill all right, title, copyright, and interest I may have in the Media Content, agree that any and all Media Content created by or on behalf of Goodwill is the property 

of Goodwill.

1. SCOPE OF PERMISSION

This release covers the following:

• My image, voice, likeness, and name;
• Statements or testimonials provided by me;
• Content captured during Goodwill-sponsored events, interviews, or activities; and
• Protected Health Information (PHI) related to my disability or disadvantage for the purpose of publicity or advertising (collectively, the “Media Content”).

I understand that:

• Media Content may be used for public information, advertising, fundraising, or other marketing  purposes aligned with Goodwill’s mission.
• No compensation is expected or required for this authorization.
• I have no right to review or approve Media Content before they are used by Goodwill, and that Goodwill has no liability to me for any editing or alteration of the Media Content or for any distortion or other effects resulting from Goodwill's editing, alteration, or use of the Media Content, or Goodwill's presentation of me.
• Any credit or other acknowledgment of me, if any, shall be determined by Goodwill in Goodwill's sole discretion

2. RELEASE PERIOD

For Goodwill Program Participants:

This release is valid from the date signed below and will expire one year (12 months) from that date unless a shorter duration is noted. Upon expiration, Goodwill will cease future use of any new content captured; however, previously published materials created, and materials that are in the process of publication within the release period may remain in circulation (e.g., social media posts, printed materials, websites).

For All Other Individuals (e.g., staff, public, volunteers):

This release is effective indefinitely unless and until such time as I provide written notice to Goodwill at this address set forth in Section 3 below that this Release is hereby revoked. Upon revocation, Goodwill will use reasonable efforts to discontinue future use of the Media Content, but existing content published 

or in the process of publication before the date of revocation may continue to appear.

3. REVOCATION

Revocations must be sent to: Attn. Marketing Department, Goodwill Industries of the Greater Chattanooga Area, 6104 Preservation Dr., Chattanooga, TN 37416. I understand that if I revoke this consent, my revocation will not have any effect on actions already taken by Goodwill.

4. RIGHTS AND UNDERSTANDINGS

I understand and agree that:

• Media Content will be used without further notification, inspection, or approval unless otherwise restricted in writing.
• Goodwill assumes no liability for use by third parties who may access public materials.
• Goodwill assumes no liability to me for any editing or alteration of the Media Content or for any distortion or other effects resulting from Goodwill’s editing, alteration, or use of the Media Content, or Goodwill’s presentation of me. 
• I may request limitations on use at the time of signing, and such limitations must be documented on this form.
• Goodwill shall be the exclusive owner of all rights including any copyright interest in the materials.

5. LEGAL CONSENT

This release is governed by the applicable laws of the State of Tennessee and State of Georgia and complies with privacy and publicity rights as outlined under both jurisdictions. I, for myself and on behalf my heirs, family members, spouses, personal representatives, executors, administrators, agents, and assigns, hereby release and discharge the Goodwill and its Representatives from any and all claims arising out of or in connection with the use of the Media Content, including, but not limited to any and all claims for defamation, invasion of privacy, or under any federal, state, or local law, regulation, or ordinance (collectively, the “Claims”). I also expressly waive all Claims. 

I represent that I am over the age of eighteen (18) years, able to consent on my behalf, and that I have read the foregoing and fully understand and agree to its contents