Houghton Mifflin Harcourt Publishing CompanyStudent Participant Release

180 Awards

DATE: ______

For any participant of the 180 awards that is under the age of eighteen and who isproviding Material as described below, parental/guardian consent is required.

Name of Student (Please print): ______Age: ______

I, the parent and/or legal guardian of the student listed above, hereby grant toHoughton Mifflin Harcourt Publishing Company, its affiliates, successors and assigns ("HMH"), for good and valuable consideration, the absolute, perpetual and irrevocable right and license with respect to the student’sappearance, name and/or voice, biographical/demographical information, audio/video recordings, writings, photographs, the results and proceeds thereof submittedin connection with the HMH 180 Awards, and any quotes or footage excerpted therefrom(the "Material"):

(a)To use, reproduce, display, exhibit, transmit, publish and distribute the Material in any and all media now known or hereafter developed, published by or under HMH’s authority including, without limitation,in connection withHMH180 Awards,HMH marketing and product materials, the website located at in whole or in part,individually or in conjunction with other material, photographs, images or text, in any language throughout the World, and for any purpose whatsoever, including, without limitation, illustration, promotion, advertising and publicity, in any media now existing or hereafter devised, including print and electronic mediums, and for any future revisions and/or editions thereof, and in the exercise of all rights related thereto;

(b)To use the student’s name, school affiliation and biographical/demographical information, in whole or in part, in connection with such use of the Material; and

(c)To copyright the Material in HMH’s name or any name that it may choose.

I acknowledge that HMH and others may use the Material including the student’s name and other information in accordance with the permission granted herein without any payment to the undersigned or any third party. I further understand that HMH is not obligated to use the Material in any manner. I represent and warrant that the student is the sole proprietor of all rights in and to any Material I or they provide; that I have full power and authority to grant the rights granted to HMH herein; that I have obtained all rights, consents and permissions, including but not limited to those of any and all persons appearing in the Material and the rights to use any and all artwork, service marks, trade names, logos, copyrighted material and/or other material depicted therein, necessary to grant the rights granted herein; and that the use of the Material by HMH as set forth above shall not violate or infringe upon the rights of any individual or entity. I also acknowledge that similar or identical material may be submitted or developed by others or HMH, to which I will not be entitled to any compensation.

I hereby waive any so-called “moral rights” in the Material, as well as all rights of inspection or approval of the Material used by HMH. I hereby release, discharge and agree to hold harmless and indemnifyHMH and those acting under its permission or authority, from any and all claims, demands or liabilities arising out of or in connection with the use, production or reproduction of the Material, including without limitation any claims for invasion of privacy or publicity, copyright infringement, breach of trademark, trespass and fraud. I also understand that the Material will not be returned to me.

I warrant under penalty of law that I am the parent or guardian of thestudent whose name and age appears above, who is less than eighteen years old. I permit the Material, referred to above, to be used by HMH, its affiliates, assignees and licensees, according to the provisions set forth above. These provisions shall carry the same force as if I had agreed to them on my own behalf.

SIGNATURE OF PARENT OR LEGAL GUARDIAN: ______

NAME OF PARENT OR LEGAL GUARDIAN (Please print): ______

SIGNATURE OF STUDENT (if 14 or older) ______

Telephone Number: ______Email Address: ______

Address: ______

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