Authorization and Consent Form - Part 1

AUTHORIZATION AND CONSENT FORM

I hereby authorize The Partition Holocaust Foundation (hereafter The Foundation), its employees and agents to interview me, to record my voice and to photograph me in connection with the creation of an archive of testimonies of survivors and witnesses of the partition holocaust that occurred in the year 1947 CE in present day India, Pakistan and Bangladesh.

I authorize The Foundation to use, and permit other persons to use, my name, picture, portrait, likeness, or recorded voice or testimony, or any or all of them, for any purpose and in any manner The Foundation may deem appropriate. I agree that my photographs or sound recordings may be used for purposes including, but not limited to, dissemination to members of the public for educational, research, scientific, public relations, and charitable purposes with the long-term goal of making them accessible to the world. I also agree that my photographs, recordings, and all reproductions thereof, including but not limited to plates, negatives and other exposed film connected therewith, are and shall remain the property of The Foundation.

I hereby grant to The Foundation, its successors and assigns and to anyone acting under the authority or permission of The Foundation, the right to make or to reproduce my photograph or recording in any form or manner, to copyright any of the originals or copies where appropriate, and to use them for any lawful broadcast or non-media broadcast purposes.

I have entered into this agreement in order to assist The Foundation in its mission of education, research, scientific, public relations, and charitable purposes and I hereby waive any right to compensation for these uses by reason of the foregoing authorizations.