SUBMISSION AGREEMENT

Are you at least 18 years of age?*

Yes

No

This Agreement is a legally binding contract and can only be executed by those over the age of 18. If you would like to submit materials for consideration of publication, please ask your legal parent/guardian to complete this contract. Sorry for the inconvenience.

Date of Birth (please include month/year)*

Date of Birth*

Who is depicted in the material that you are wishing to submit?*

The material that I wish to submit are depicting me.

The material that I wish to submit are depicting a family member.

Someone else

Is your family member that is depicted in the material that you are seeking to submit your minor child?

Yes

No

Are you the legal parent/guardian of this child?*

Yes

No

Do you affirm that you have legal right to submit this information on their behalf?

Yes

No

This Agreement is a legally binding contract and can only be executed by the person being depicted, their legal parent/guardian, or someone with the legal right to share and release their personal information. Sorry for the inconvenience.

Today's Date*

Your Name (the “Submitter,” and collectively the “Parties”)*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

What are you intending on submitting or giving your permission for?*

A one time photo/image or audio/video footage (including MRI image)

A one time written piece (story)

A one time written piece (story) with images specifically given to accompany the story

I’d like to keep this contract on file to cover ALL that I will submit now and in the future

Who would you like to give permission to use your submitted material?*

Chiari Bridges, Inc./Worth The Fight (WTF!), exclusivel

Michelle Cole (via Chiari Bridges, Inc./Worth The Fight (WTF!) as well as future Chiari/Comorbid Awareness efforts that may be done under a new/additional name), hereby referred to collectively as “Michelle Cole.”

Chiari Bridges is a California Public Benefit Corporation formed under the laws of California to render charitable services.
Michelle Cole is the founder and CEO of both

Acknowledgement*

I acknowledge that I am voluntarily opting to make this AGREEMENT not just with Chiari Bridges, Inc., but with Michelle Cole (via Chiari Bridges, Inc./Worth The Fight (WTF!) as well as future Chiari/Comorbid Awareness efforts that may be done under a new/additional name), hereby referred to collectively as “Michelle Cole.”

It is agreed by and between the parties as follows:

Section 1. Submission of Material.

Please check that you agree to each of the following.

Item 1.1.*

The material, documents, and information being submitted to Chiari Bridges, Inc./Worth The Fight (WTF!) under the terms of this Agreement, including all ideas, elements, and their expression contained therein, are referred to collectively as the “Material.”

Item 1.1.*

The material, documents, and information being submitted to Michelle Cole under the terms of this Agreement, including all ideas, elements, and their expression contained therein, are referred to collectively as the “Material.”

Item 1.2.*

The submission of the Material to Chiari Bridges, Inc./Worth The Fight (WTF!) is voluntary, not solicited and not in confidence.

Item 1.2.*

The submission of the Material to Michelle Cole is voluntary, not solicited and not in confidence.

Item 1.3.*

The Submitter warrants that s/he is either the author or owner of all rights to the Material, or the duly authorized agent of the lawful owner of the Material, and that the Submitter has full power and authority to submit the Material to Chiari Bridges, Inc./Worth The Fight (WTF!) and that no further consents from third parties are required. In other words, the Material must be an original work and should not contain any content appropriated from other sources.

Item 1.3.*

The Submitter warrants that s/he is either the author or owner of all rights to the Material, or the duly authorized agent of the lawful owner of the Material, and that the Submitter has full power and authority to submit the Material to Michelle Cole and that no further consents from third parties are required. In other words, the Material must be an original work and should not contain any content appropriated from other sources.

Item 1.4.*

For created images and original “medically related research articles” (hereby referred to as “article.”), upon submission of the Material to Chiari Bridges, Inc./Worth The Fight (WTF!), the Submitter agrees and warrants that the Submitter waives the right to later submit the Material to another entity or organization. For example, if a created image and/or article is submitted to Chiari Bridges, Inc./Worth The Fight (WTF!), the Submitter agrees that s/he will not later submit the same image and/or article to another website for publication.

Item 1.4.*

For created images and original “medically related research articles” (hereby referred to as “article.”), upon submission of the Material to Michelle Cole, the Submitter agrees and warrants that the Submitter waives the right to later submit the Material to another entity or organization. For example, if a created image and/or article is submitted to Michelle Cole, the Submitter agrees that s/he will not later submit the same image and/or article to another website for publication.

Section 4. Confidentiality.

Please check that you agree to each of the following.

Item 4.1.*

Under the course of dealing between Chiari Bridges, Inc./Worth The Fight (WTF!) and Submitter, it is possible that the Submitter may have access to certain confidential information, including the names, nicknames, or personally identifiable information of other Submitters. In the event that Submitter obtains any such information, Submitter agrees not to utilize or disclose such information to any person, firm, corporation, or association, either directly or indirectly, and in any manner at all. Submitter should maintain this information as confidential.

Item 4.1.*

Under the course of dealing between Michelle Cole and Submitter, it is possible that the Submitter may have access to certain confidential information, including the names, nicknames, or personally identifiable information of other Submitters. In the event that Submitter obtains any such information, Submitter agrees not to utilize or disclose such information to any person, firm, corporation, or association, either directly or indirectly, and in any manner at all. Submitter should maintain this information as confidential.

Section 5. No Compensation.

Please check that you agree to each of the following.

Item 5.1.*

The Submitter is not provided with any monetary compensation in exchange for the Material.

Item 5.2.*

The Submitter shall not be considered either an employee or an agent of Chiari Bridges, Inc./Worth The Fight (WTF!).

Item 5.2.*

The Submitter shall not be considered either an employee or an agent of Michelle Cole (via Chiari Bridges, Inc. (“Chiari Bridges”), Chiari Rhapsody, WTF! Worth the Fight, and any other Chiari/Comorbid Awareness efforts in the future).

Section 6. Miscellaneous.

Please check that you agree to each of the following.

Item 6.1.*

Notices. All future notices under this Agreement shall be sent to the parties at the following respective addresses and/or e-mail addresses: Chiari Bridges, Inc., PO Box 4027, Santa Clara, CA 95056 and/or legal@ChiariBridges.org

Item 6.1.*

Notices. All future notices under this Agreement shall be sent to the parties at the following respective addresses and/or e-mail addresses: Michelle Cole c/o Chiari Bridges: PO Box 4027, Santa Clara, CA 95056 and/or legal@ChiariBridges.org

Item 6.1(i). Change of Address*

A change in the address of any party may be affected by serving written notice of such change and of such new address upon the other party.

Item 6.2.*

Invalidity. The invalidity or unenforceability of any provision or provisions of this Agreement shall not affect the other provisions, and this Agreement shall be construed in all respects as if any invalid or unenforceable provisions were omitted.

Item 6.3.*

Arbitration. All disputes, differences and controversies arising out of, under, or in connection with this Agreement shall be settled and finally determined by Arbitration in the State of California, under the then existing Rules of the American Arbitration Association.

Item 6.4.*

Entire Agreement & Waiver. This Agreement represents the entire understanding and agreement between the parties hereto with respect to the subject matter hereof and cannot be amended, supplemented or modified except by an instrument in writing signed by the party or parties against whom enforcement of any amendment, supplement or modification is sought. A waiver by a party of any breach of any provision of this stipulation shall not be construed to be a waiver by any such party of any succeeding breach of such provision or a waiver by such party of any breach of any other provision.

Item 6.5.*

Counterparts & Electronic Signatures. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original, but together shall constitute one and the same instrument. Scanned, electronic (/s/), or facsimile signatures shall be treated in all manner and respects as original signatures.

Item 6.6.*

Fees and Expenses. Each Party shall be responsible for the payment of its own legal fees and costs, and all of its expenses in connection with the matters referred to in this Agreement.

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It is agreed by and between the parties as follows:

Section 1. Submission of Material.

Section 2. Ownership of Material.

Section 3. Use of Material.

Section 4. Confidentiality.

Section 5. No Compensation.

Section 6. Miscellaneous.

Section 7. Consent and Notice Regarding Electronic Communications for Michelle Cole (via Chiari Bridges, Inc. (“Chiari Bridges”), Chiari Rhapsody, WTF! Worth the Fight, and any other Chiari/Comorbid Awareness effort in the future).

Section 7. Consent and Notice Regarding Electronic Communications for Chiari Bridges, Inc. (“Chiari Bridges”).