Download PDF of the Release Form

Effective Date: ________________
Name of Releasor: _____________
Address of Releasor: ___________

The party listed above will refer to themselves throughout this document as "the Releasor," "I," and through the use of other first-person pronouns.

I, the Releasor, hereby and irrevocably consent to the use, publication, distribution, broadcasting, reproduction, editing, recording, posting, copyrighting, licensing, digitization, and/or re-release of the Released Item(s), as defined below, by NUC USA, Inc., an Illinois corporation d/b/a Kuvings, having its principal place of business at 236 Egidi Drive, Suite C, Wheeling, IL 60090, (“Company”), as well as any employees, affiliates, associates, representatives, assignees, or agents of the Company (collectively referred to as the "Release Receiver") for any legal reason or purpose, including but not limited to social media, commercial products, education, course materials, video footage, sales, marketing, or any other medium in any form that has been or will be invented.

I agree that this consent is realized and enforceable as of the Effective Date listed at the head of this document.

The Released Item(s) subject to this Release are defined and described on the attached Exhibit A. In consideration of irrevocable consent by the Releasor, the Release Receiver may or may not provide monetary and/or equivalent consideration to Releasor. In the event a monetary and/or equivalent consideration is given to the Releasor, such consideration is fully described in Exhibit A.

I shall not sue nor bring any action against the Release Receiver regarding the Release Item(s). I hereby release the Release Receiver from any and all claims and demands arising out of or in connection with any use of the Released Item(s), including, without limitation, claims for privacy violations, right of publicity claims, defamation and/or any other intellectual property rights. I claim no ownership of the Released Item(s) and forego any opportunity, whether past or present, to copyright or trademark the Released Item(s).

I give consent to the use of the Released Item(s) while knowing and understanding that my name, comments, and other identifying factors may be revealed to the general public. However, the Release Receiver may not make known to any party in any medium my known or previously known location, email or physical address, or any other contact details, such as my phone number.

I represent and warrant to the Release Receiver that I have the power and authority to authorize this Release and that the Released Item(s) will not violate the intellectual property rights of any third party.

I indemnify and hold the Release Receiver harmless from any damage or cost, which may include reasonable attorneys' fees, arising from or in connection with the use of the Released Item(s).

This Release represents the entire understanding between the parties listed above and supersedes all previous representations, understandings or agreement. No waiver, modification or cancellation of any term or condition of this Release shall be effective unless signed in writing by both parties.

This Release shall be governed by the laws of Illinois. If any part of this Release is found to be invalid, the remainder of the Release shall remain in full force and effect to the maximum extent permitted by law.

I am over eighteen years of age and have full legal rights and authority to consent to the terms of this Release.


Signature of Releasor: ____________________
Date: ______________


EXHIBIT “A” to Video/Photo/Testimonial Release Form

Effective Date: _______
Name of Releasor: __________________
Description of Released Item(s):

Consideration paid to Releasor: