Program Title: Medicine Teachings with George Bertelstein: (the “Video”)
Person Appearing: (Your Name Here)
Production Date: January - April 2021
Production Location: Zoom Classroom
Producer: George Bertelstein

I authorize the Producer and the Producer’s agents, successors, assigns, and designees to record my name, likeness, image, voice, sound effects, interview and performance on tape, or otherwise (the "Recording"), edit such Recording as Producer may desire, and incorporate such Recording into the Video, any versions of the Video and all related materials thereof, including but not limited to promotion and advertising materials. It is understood and agreed that the Producer shall retain final editorial, artistic, and technical control of the Video and the content of the Video. The Producer may use, and authorize others to use the Video, any portions thereof, and the Recording in all markets, manner, formats, and media, whether now known or hereafter developed, throughout the world, in perpetuity. Producer, and Producer’s successors and assigns, shall own all right, title and interest, including the copyright, in and to the Video, including the Recording and related materials, to be used and disposed of, without limitation, as Producer shall in Producer’s sole discretion determine.