RELEASE FORM

In consideration of the Government of Singapore c/o National Youth Council (“NYC”) featuring me in
the media story / media interview / photoshoot set out below, I
_____________________________________________________ (name of individual being
featured), hereby give NYC, its assigns, licensees and legal representatives, the absolute and
irrevocable right, including all intellectual property rights, to use all content within any photographs,
audio and video recordings made of me (whether exclusively of me or otherwise) on [DD MM YYYY]
at [Location] (“Content”), in all forms, including in whole or part, in all manner and in all media and
formats, for education, advertising, and publicity purposes of NYC.

I release and agree to hold harmless NYC and its assigns, licensees, and legal representatives from
any liability whatsoever and howsoever arising, by virtue of any blurring, trimming, cutting, editing,
colouring or use in any composite form that may occur in the Content (whether exclusively of me or
otherwise), or in any processing tending towards the completion of the finished product.

I further agree that:

(a) The Content may be combined with other images, text, graphics, film, audio, audio-visual
works; and may be cropped, altered or modified in NYC’s full discretion.

(b) My participation in the Content does not confer upon me any title, right or interest
(including intellectual property rights) in the whole or part of any materials created as part of the
process of the production, and I hereby waive any claim that I may have based on any use of the
Content by NYC. I agree that NYC owns absolutely all intellectual property rights in the Content.

(c) I have consented to voluntarily appear in the media story/media interview/photo shoot and
for the Content to be made for that purpose.

(d) I will bear all responsibility associated with being profiled in the media and will not hold NYC
responsible for how I/my organisation is portrayed by the media.

(e) The views expressed by myself/my organisation may not necessarily reflect the views of
NYC.

(f) This release form shall be legally binding on me, my legal representatives and assigns. I have
read this release form and confirm that I fully understand and agree to all its contents.
Personal details of individual being featured:

Name: Contact Number:

Sex: Male / Female Email:

Last 4 digits of NRIC: Year of Birth:

I agree that ALL information provided above is accurate.

Signature and date:

Personal Details of Parent or Guardian (if individual is below 21 years old)

Name: Contact Number:

Sex: Male / Female Email:

Relationship with individual

being featured:

Signature and date: