Consent, Permission and Release Terms

CONSENT, PERMISSION, AND RELEASE

Boston Scientific Corporation, and its affiliates, and their respective employees, representatives, agents, successors and assigns (all of the foregoing, collectively, “BSC”) hereby requests your unrestricted permission and right to use identifiable or de-identifiable images, photos, drawings, videos, authored material, copyrighted material, endoscopic or procedural material, or audio provided, collected, or created during or as a result of your participation in the above-referenced Purpose (all of the foregoing, collectively, “Materials”).In the event that the Materials are subject to any prior agreement(s) between you and BSC, the terms of the prior agreement(s) shall control and supersede this agreement to the extent that the terms herein are inconsistent with the terms of the prior agreement(s).

By submitting, you hereby:

• Grant to BSC the unrestricted worldwide, non-exclusive, perpetual right and permission to use, display, distribute, broadcast, copyright, edit, publish, and/or reprint the Materials, in whole or in part, in all languages, forms and media (print and non-print, electronic or otherwise), for any legitimate business purpose, and to reproduce the same through any media, including social media (all of the foregoing, collectively, “Use”);
• Grant to BSC the unrestricted right and permission to use and publish your name and the name of the institution with which you are associated (all of the foregoing, collectively, “Names”) in connection with Use of the Materials, provided that BSC shall not be obligated to do so;
• Grant to BSC the unrestricted right and permission to license any of the foregoing rights and permissions to third parties;
• Release BSC and agree to hold it harmless, and any person or entity acting on its behalf, from and against any liability arising out of any activity with respect to which permission has been granted or rights have been waived hereunder, including without limitation any liability arising out of any editing, distortion, alteration, illusion or use in composite or derivative form, of the Materials as part of any Use, either intentionally or otherwise, that may occur or be produced in the development, production, processing or reproduction of the Materials in a finished product (“Product”);
• Waive any rights to inspect or approve any Product, including without limitation any finished videotape, soundtrack, digital media (including website postings and social media) or printed or electronic matter;
• Certify, agree, represent, and warrant that:  (a) you possess the unrestricted right and power to grant the above permissions and to agree to the foregoing; (b) the grants and agreements set forth above are not in violation of any agreements or restrictions to which you may be subject, whether imposed by law, contract, institutional policies or procedures, or otherwise; (c) you are solely responsible for the content of any disclosure or discussion by you as part of any of the Materials, including any disclosure relating to any medical history and/or any medical procedure or condition; and (d) you are over 21 years of age and competent to contract in your own name insofar as the foregoing is concerned;
• Authorize the disclosure of Materials to the extent they include protected health information subject to the requirements of the Health Insurance Portability and Accountability Act (HIPAA);
• Agree that this document shall be construed as an agreement under seal under the laws of the Commonwealth of Massachusetts (for the United States), without regard to conflict of laws principles; and
• Certify that you have read the foregoing before submitting and represent and warrant that you fully understand the foregoing.