Kaiser Permanente Release and Consent Agreement

Prior to Kaiser Permanente’s use of your submitted photos, videos, audio, name, and creative works (collectively “content”) you must agree to this Release and Consent Agreement.  By clicking "Agree" you agree that:

(1) You are at least 18 years old; and

(2) You have read and agree to this Release and Consent Agreement for Photos, Videos, Audio, Name and Creative Works.

A link to this Release and Consent Agreement is provided on the Kaiser Permanente website.  Please note that if guests or children are identifiable within the content that you submit, a separate Release and Consent Agreement signed by the guest or the parent/guardian of the minor will need to be provided to Kaiser Permanente.

“Kaiser Permanente” means Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals, the Permanente Medical Groups, The Permanente Federation LLC, and each of their affiliates and subsidiaries and their respective directors, officers, employees, agents, customers, successors and assigns.

Release and Consent for Photos, Video, Audio, Name and Creative Works

In exchange for valuable consideration received (including any and everything you might have received from Kaiser Permanente in exchange for your participation, whether it’s a gift or just the fun of being a part of our promotional activities) I hereby consent to the unrestricted use for or by Kaiser Permanente of the following content: 

  • Photographs/Video Recordings: any and all photographs and/or video recordings taken of me and all images created from such recordings (collectively “Images”).
  • Audio Recordings: any and all audio recordings made of my voice and all recordings created from such recordings.
  • Name/Statements: my name and any stories, statements or quotes I have provided (whether quoted or paraphrased, with or without enhancements).
  • My Personal Artwork, Photos, or Other Creative Works: paintings, songs, stories, videos, photographs or other original, creative works (“Creative Works”) which I created and have submitted to Kaiser Permanente for its use.

Scope of Consent.  Kaiser Permanente may use my name, Images, audio recordings, statements and/or Creative Works as indicated above, for any and all purposes, including but not limited to use in promotional materials, health education materials, public relations, professional education, and art, and in all media, including electronic, digital, Internet, and print media, without further compensation to me.  I certify that I am not a minor and am free and able to give such consent.

Waiver. I waive any right to approve: (1) the finished photographs, Images, audio recordings and/or statements made by me, and any marketing materials or other printed, video or digital matter that may be used in connection with my name, Images, audio recordings, statements and/or Creative Works; and (2) the eventual use of any of the foregoing. I acknowledge that Kaiser Permanente owns all rights in the photographs, Images, audio recordings and/or statements made by me and I waive any claims that I have or may have based on its usage of them or any works derived from them.

License. As to the Creative Works, I hereby grant to Kaiser Permanente a world-wide, non-exclusive, royalty-free, irrevocable, sublicensable and transferable license to use, distribute, modify, reproduce, publicly perform and publicly display the Creative Works and any related materials for any and all purposes and in all media.

Release and Warranty.  I hereby release and hold harmless Kaiser Permanente from all damages and liability that may arise from or in connection with the use of my name, Images, audio recordings, statements and/or Creative Works. I warrant and affirm that I own all rights in the Creative Works and have the full legal right and authority to grant Kaiser Permanente permission to use them. I further warrant that I have the written consent of each and every identifiable individual person in my Creative Works to use their likeness for the purposes identified herein.