First Name *
Last Name *
Email *
Telephone Number! *
City *
State *
Age (DOB) *
How Active Are You? *
What is your favorite outside activity?
Do you have any hobbies? *
How long have you been single? *
What are you looking for in a partner? (Please be specific)
For good and valuable consideration, receipt of which is herby acknowledged, I hereby grant to AARP and its affiliates the right and permission with respect to any picture, film, video, telecast, and/or filmstrip (“the Project”) made by or produced for AARP to use, record, reproduce, distribute, edit, reuse, transmit, publish and republish my name, photograph, voice, materials, sounds, image, likeness, performance and appearances in any manner, in whole or in part, individually or in conjunction with other materials, in any medium, now known or hereafter developed (including, without limitation, radio, television, Internet streaming and downloads), and for any purpose whatsoever throughout the world, an unlimited number of times in perpetuity, including (but not by way of limitation) illustration, promotion and advertising, including the right to edit or modify the Project. I understand that AARP either owns the copyright and all other rights in and to the Project or has an irrevocable, worldwide, royalty free right to use the Project in any manner. I also understand that I will not have any right of approval or receive any compensation as a result of any use or re-use of the Project. I hereby waive any rights of privacy or publicity that I may have with respect to the Project and any use or re-use of the Project. I acknowledge that AARP will rely on this permission potentially, at substantial cost to AARP and hereby agree not to assert any claim of any nature whatsoever against anyone relating to the exercise of the permissions granted hereunder. I represent that any statements made by me during the Project are true, to the best of my knowledge, and that neither they nor my appearance nor my materials will violate or infringe upon the rights of any third party. I release and discharge AARP and its affiliated companies from any and all claims and demands arising out of or in connection with the Project, including, without limitation any and all claims based on rights of publicity or privacy, or for defamation. *
If the person appearing in the Project is under the age of 21, his/her parent or legal guardian must sign this release. *
I represent that I am the parent or legal guardian of *
I have read and fully understand the contents of this release, and that I consent to this release on behalf of