Tulsa Remote

Program Terms and Conditions

TULSA REMOTE

PROGRAM AGREEMENT

THIS REMOTE PROGRAM AGREEMENT (“Agreement”) is entered into and shall be effective as of the date listed in the signature block to this Agreement (the “Effective Date”), by and among Tulsa Remote, LLC (“Tulsa Remote”), a limited liability company having an office at 7030 S. Yale Avenue, #600, Tulsa, Oklahoma 74136-5749, and a natural person (“Recipient”). Tulsa Remote and Recipient shall be collectively referred to as the “Parties” and individually as a “Party”. 

RECITALS

WHEREAS, Tulsa Remote is designed to recruit a talented work-force to the city of Tulsa, Oklahoma through a remote-working relocation plan (“Program”); 

WHEREAS, Remote workers are a growing part of the economy with the ability to live and work in Tulsa while being employed full time by a company outside of Oklahoma (“Remote Workers”); 

WHEREAS, Recipient currently resides outside of Oklahoma; 

WHEREAS, Recipient is “Remote Working,” defined as being either self-employed or a Remote Worker, on the Effective Date and will continue Remote Working for at least twelve (12) consecutive months from the Effective Date; 

WHEREAS, Tulsa Remote desires to offer Recipient an incentive for moving to Tulsa, Oklahoma, subject to the terms and conditions below; 

WHEREAS, Tulsa Remote desires to offer Recipient an incentive for living and Remote Working in Tulsa, Oklahoma for twelve (12) consecutive months, in order to encourage longer term residency in Tulsa, subject to the terms and conditions below; and 

WHEREAS, Recipient desires to accept the incentives subject to the terms and conditions below. 

NOW THEREFORE, in consideration of the foregoing premises, the mutual covenants set out below, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree as follows: 

1. TERM OF PROGRAM

Recipient agrees to establish residency within the limits of the city of Tulsa, Oklahoma no later than ____________________ (“Start Date”). The term of the Program is twelve (12) consecutive months from Start Date (“Program Term”). Recipients shall provide evidence of such residency pursuant to Sections 4 before receiving financial benefit. 

2. ORIENTATION

Recipient agrees to attend a Program orientation, the time and date of which will be provided to Recipient in writing at least fourteen days (14) days prior to the day of orientation. Any document signed by Recipient at the orientation shall be incorporated herein by reference and made a part of this Agreement as if fully set forth herein. 

3. INCENTIVES

A. Financial Incentives

Subject to Recipient’s full compliance with the terms of this Agreement, Tulsa Remote agrees to pay to Recipient a total incentive of ten thousand dollars ($10,000.00) (the “Program Incentive”) for the Program Term, to be paid in one of the two formats below.

i. The “Monthly Incentive” Option will be paid as follows:

  1. Relocation. Upon relocation within the Tulsa city limits and Recipient providing Tulsa Remote with sufficient residency documentation pursuant to Section 4, Recipient will receive two-thousand five hundred dollars ($2,500.00) (“Relocation Incentive”). 
  2. Monthly Incentives. Monthly incentives of five hundred dollars ($500.00) for twelve (12) consecutive months for living within the city of Tulsa and abiding by the terms and conditions of Agreement each month (each a “Monthly Incentive”). 
  3. Completion of Program. Upon completion of living within the city of Tulsa and abiding by the terms and conditions of Agreement for twelve (12) consecutive months, Recipient will receive one thousand five hundred dollars ($1,500.00) (“Completion Incentive”). 
  4. The Relocation Incentive will be paid to Recipient by direct deposit. If Program Requirements are met, Tulsa Remote will direct deposit the Monthly Incentive and Completion Incentive.  Subject to individual facts and circumstances which call for an accommodation as determined by Tulsa Remote, use of post office boxes will not be permitted. 

ii. The “Homeownership Incentive” Option will be paid out as follows:

    1. In the events that each of the following occur: (a) the Recipient promises (represents and warrants) that the Recipient has purchased in connection with the Program and will live in a “Recipient Occupied Personal Residence,” as defined in Paragraph 3(A)(ii)(b) below, in the City of Tulsa for the remainder of the Program Term; (b) the Recipient provides proof, to the satisfaction of Tulsa Remote, of Recipient’s purchase of a Recipient Occupied Personal Residence in the City of Tulsa in connection with and for the remainder of the Program Term; (c) the Recipient promises (represents and warrants) that the Recipient will receive no income from the residence for the Program Term (unless as explicitly excepted in Paragraph 3(A)(ii)(d) below for remote work as represented), and (d) the Recipient is explicitly named as a title-holder to the Recipient Occupied Personal Residence, Tulsa Remote shall pay the remainder of unpaid Program Incentives in one lump sum (Homeownership Incentive). 
    2. Recipient Occupied Personal Residence” is defined as a City of Tulsa residential property that Recipient purchases in connection with the Program to be Recipient’s primary residence, and in which Recipient is an owner-occupant for at least one calendar year. Properties purchased as and/or used as vacation or second homes, as part-time homes, or for the benefit of another and/or for commercial purposes (such as for rental) are excluded.
    3. Tulsa Remote may require the following as proof of the purchase of a Recipient Occupied Personal Residence: filed-stamped and certified deed, note, mortgage, tax records, utility bills, and the like. 
    4. The Recipient’s promises (representations and warranties) set forth in Paragraph 3(A)(ii)(a) that the Recipient will receive no income from the residence for the Program Term of the Agreement specifically prohibit any income producing use of the residence (prohibit commercial use such as renting the residence in whole or in part and prohibit any commercial use of the property during the Program Term), with the sole exception of the remote work as represented in Recipient’s application to Tulsa Remote. 
    5. In the event that Recipient breaches the promises (representations and warranties) set forth in the Agreement as Amended), the Recipient shall be required to reimburse Tulsa Remote the Homeownership Incentive ten days following written demand for reimbursement by Tulsa Remote.
    6. Upon satisfaction, as determined solely by Tulsa Remote, of the requirements of the Homeownership Incentive as defined in Paragraph (3)(A)(ii), Tulsa Remote will make the payment of the remaining Program Incentive in a Lump Sum, in the course of Tulsa Remote’s regular disbursement schedule. 

B. Incentive Cap

In no event shall the Financial Incentives pursuant to the Program exceed a total of ten thousand dollars ($10,000.00). 

C. Taxes Not Withheld

Any incentive pursuant to the Program is not a grant, it is income. Tulsa Remote will not withhold taxes of any kind from Recipient’s Program Incentive, but will provide an IRS Form 1099. It is the responsibility of Recipient to report Program Incentive income to the appropriate state and federal tax authorities and to pay any taxes due on such income. The Participant agrees to indemnify and defend Tulsa Remote for any tax issues associated with payment of Financial Incentives. 

D. Mandatory Survey Completion

It is a mandatory requirement to receive financial incentive that each Recipient timely complete mandatory surveys regarding satisfaction with the experience with Tulsa Remote and the City of Tulsa. 

4. PROOF OF CITY OF TULSA RESIDENCY

For the Program Term, Recipient agrees to reside within the boundaries of the City of Tulsa, Oklahoma. Before Recipient is eligible to receive Program Incentives and at any time during the Program Term at the upon the request of Tulsa Remote, Recipient must provide Tulsa Remote with a W-9 listing the Recipient’s city of Tulsa Residency address, and a copy of Recipient’s lease or filed-stamped property deed in Recipient’s name. 

If, for any reason Recipient is unable to maintain residency in Tulsa or Remote Working status during the twelve months, then Tulsa Remote may, in its sole and exclusive discretion: (i) withhold or prorate some or all Program Incentive; or (ii) terminate Recipient from the Program in which case the consequences of termination set out in Section 8 and 9 shall apply. Any issues with inability to maintain residency or Remote Working status shall be directed to the Program Director in writing as soon as such issues arise and/or are anticipated, whichever occurs first. 

5. COMMUNITY INTEGRATION 

From time to time, Tulsa Remote may provide voluntary opportunities for integration into the Tulsa community. Such voluntary opportunities will be posted on the Tulsa Remote Website and/or email from Tulsa Remote. Attendance at such opportunities is subject to the general release, Indemnity and Hold Harmless and Indemnity set out in Paragraphs 10 and 11 below. 

6. PHOTOGRAPH AND MEDIA RELEASE AND WAIVER

Recipient agrees to sign, or has previously signed, the attached Photograph and Media Release and Waiver (“Waiver”), attached hereto as Exhibit A and incorporated herein by this reference. The terms of the Waiver are incorporated herein by reference. The Waiver shall be effective upon Recipient’s execution of the Agreement. 

When engaged with media regarding Program, Recipient hereby agrees to abide by the Code of Conduct below. 

7. CODE OF CONDUCT 

A. Diversity, Equity, Inclusion

Recipient acknowledges and agrees that Recipient’s conduct may directly affect the community’s opinion of the Program. Tulsa Remote expects that all Recipients share Tulsa Remote’s value that communities are greatly enriched through diversity of people. In furtherance of this value and of making a positive impact on the Tulsa community, Recipient agrees, at all times when engaged in the Program and/or Program opportunities, to be professional, employ ethical practices and demonstrate respect for others, including without limitation, respect of personal and cultural differences. 

B. Compliance with Applicable Laws

Recipient will comply with all applicable laws. Recipient shall not engage in any behavior that endangers the safety of others or cause others to feel endangered, commit any crime or criminal act(s) or otherwise engage in behavior of moral turpitude (conduct that is considered contrary to community standards of justice, honesty or good morals). If Recipient engages in the commission of a crime as determined in the sole discretion of Tulsa Remote, Tulsa Remote may deem the Recipient to be in material breach of this Agreement and Tulsa Remote may terminate Recipient from the Program. 

C. Quality Jobs Incentive Requirements, Promises, Representations and Warranties, and Data Requirements of Recipients.

Tulsa Remote requires that each Recipient provide information in order that Tulsa Remote may receive applicable rebates pursuant to the Oklahoma Remote Quality Jobs Incentive Act.  68 O.S. 4501 et seq. 

By participating in Tulsa Remote, each Recipient, is throughout the term of this Agreement and for two years thereafter, such that Tulsa Remote has three complete years of promises, representations and warranties, and data for Recipient:

  • Is representing and warranting to Tulsa Remote and the State of Oklahoma that the Recipient has not lived in the State of Oklahoma for the twelve months previous to the Recipient’s application to Tulsa Remote. 
  • Promising to timely provide to Tulsa Remote satisfactory proof of basic health benefits for the Recipient which meet all of the requirements of this paragraph (C); 
  • Representing and warranting to Tulsa Remote and the State of Oklahoma that not more than fifty percent of the premium payments for said health benefits are paid by the Participant;
  • Representing and warranting that said health benefits include coverage for:  basic hospital care, physician care, mental health care, substance abuse treatment, coverage for prescription drug; and prenatal care.  
  • Representing and warranting to Tulsa Remote that the Participant will we working an average of thirty (30) or more hours per week. 
  • Representing and warranting to Tulsa Remote and the State of Oklahoma that the Participant will receive average annualized wages in excess of the greater of: (i)  $25,000.00 or (ii) the latest Consumer Price Index year  to date percentage change for Tulsa County. 
  • Promising to timely provide to Tulsa Remote satisfactory proof of payroll statements and/or other documentation of withholding taxes paid to the State of Oklahoma for the Recipient. 

Recipient understands that failure to provide information promised herein satisfactory to Tulsa Remote in Compliance with this paragraph constitutes a violation of the Code of Conduct and this Agreement and may result in immediate suspension of Financial Incentive.  Further, Tulsa Remote reserves the right to recover all Financial Incentive from Recipient for a violation of this Paragraph.    

Recipient understands that: 

Any person making an application, claim for payment or any report, return, statement or other instrument or providing any other information pursuant to the provisions of this act who willfully makes a false or fraudulent application, claim, report, return, statement, invoice or other instrument or who willfully provides any false or fraudulent information, or any person who willfully aids or abets another in making such false or fraudulent application, claim, report, return, statement, invoice or other instrument or who willfully aids or abets another in providing any false or fraudulent information, upon conviction, shall be guilty of a felony punishable by the imposition of a fine of not less than One Thousand Dollars ($1,000.00) and not more than Fifty Thousand Dollars ($50,000.00), or imprisonment in the State Penitentiary for not less than two (2) years and not more than five (5) years, or by both such fine and imprisonment. Any person convicted of a violation of this section shall be liable for the repayment of all incentive payments which were paid to the establishment. Interest shall be due on such payments at the rate of ten percent (10%) per annum. 

68 O.S. 4509. 

D. EQUAL OPPORTUNITY

i. Purpose

It is Tulsa Remote’s goal that there shall be no discrimination with respect to selection of Recipients and/or administration of the Program on account of race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability or genetic information or military or veteran status (“protected category”). 

ii. Anti-Harassment Policy

Harassment” is defined as unwelcome conduct that is based on a protected category that is severe or pervasive enough to create an environment that a reasonable person would consider intimidating, hostile, or abusive. Petty slights, annoyances, and isolated incidents (unless extremely serious) will not rise to the level of Harassment. Offensive conduct may include, but is not limited to, offensive jokes, slurs, epithets or name calling, physical assaults or threats, intimidation, ridicule or mockery, insults or put-downs, offensive objects or pictures, stalking, intrusive photography and/or recording without consent. 

Prohibited Harassment will not be tolerated by Tulsa Remote and anyone asked to stop harassment by Tulsa Remote is expected to comply immediately. 

If Recipient behaves unacceptably, Tulsa Remote may take any action it deems appropriate, including expulsion from the Program (Termination), effective immediately upon notice. 

iii. Reporting

If Recipient observes a violation of this section, or considers himself/herself to be a victim of the above behaviors by another Recipient, Recipient shall immediately report the violation to the Program Director. Tulsa Remote will take reasonable steps to maintain reasonable confidentiality when conducting investigations and resolving complaints of Harassment. 

iv. Grievance Procedure

Tulsa Remote understands that issues may arise resulting in grievances, complaints and/or or concerns about the Program or related matters and Tulsa Remote desires to resolve such matters. Tulsa Remote requires the opportunity to address such issues. Recipient agrees to timely communicate about grievances, complaints, and/or concerns with Tulsa Remote in furtherance of achieving Tulsa Remote’s desire. Grievances, complaints, and/or concerns shall be addressed to the Program’s Chief Operating Officer. If the grievance, complaint, and/or concern is with the Program’s Chief Operating Officer, contact Counsel for Tulsa Remote by emailing [email protected].

8. TERMINATION

Tulsa Remote may, at its sole and exclusive option, terminate Recipient’s participation in the Program for any of the following non-exclusive reasons (all of which are considered material breaches of this Agreement), effective immediately upon notice: 

A. Failure to Establish and/or Maintain Residency

Failure to establish and maintain residency within the City of Tulsa by Start Date and throughout the immediately-following, consecutive twelve months. 

B. Failure of Represented Remote Work

Failure, during the Program Term, to be employed by the remote employer and/or to work remotely if self-employment is permitted. 

C. Misrepresentations to Tulsa Remote, including, but not limited to: 

  1. Inaccurate or misleading application or proof of application requirements; 
  2. Inaccurate or misleading proof of Tulsa residency; 
  3. Misrepresentations with respect to Tulsa residency; 
  4. Misrepresentations to Tulsa Remote in the context of a harassment investigation and/or grievance procedure. 

D. Violations of the Code of Conduct;

E. Commission of any felony or of a misdemeanor or other crime which may affect the reputation of Tulsa Remote; 

F. Any breach of Section 3, 4, 6 or 7 of this Agreement, whether or not material; 

G. Tulsa Remote reasonably believes that Recipient’s behavior does or will jeopardize the quality of the experience for other Recipients, Tulsa Remote, and/or collaboration with community organizations; or 

H. Any violation of this Agreement that may be non-material but is severe and/or pervasive; or 

I. Any other reason which constitutes a material breach of this Agreement. 


9. EFFECT OF TERMINATION 

If Recipient is terminated from the Program: (i) Recipient will not be eligible for unpaid Monthly Incentive, Completion Incentive, and/or a portion of the Homeownership Incentive already paid, and (ii)Tulsa Remote will have no further obligations to Recipient. Tulsa Remote reserves the right to collect a prorated portion of the Program Incentive already paid, beginning at the time Recipient breaches this Agreement.

10. RELEASE, INDEMNITY AND HOLD HARMLESS 

A. General Release

In consideration of participation in the Program, Recipient, on behalf of himself/herself/them self and all heirs, assigns, and personal representatives, and anyone claiming on behalf of or through any of the foregoing (together “Releasor(s)”), does hereby irrevocably and unconditionally release, acquit, forgive and forever discharge Tulsa Remote and its affiliates, successors and assigns, as well as its and their respective past and present officers, directors, manager, employees, and shareholders (collectively the “Releasees“), in the individual and/or corporate capacity(ies) of each, from any and all claims, suits, debts, covenants, contracts, demands, controversies, trespasses, agreements, liabilities, promises, actions, damages and any other costs and expenses of whosoever kind or nature (together the “Claims”), whether known or unknown, liquidated or unliquidated, which any Releasor ever had or will have from the beginning of time through the end of time against any of the Releasees based upon, arising out of or in any way relating to this Agreement, participation in the Program and any activity connected therewith. 

B. Recipient to Indemnify and Hold Harmless Tulsa Remote

Recipient shall indemnify and hold Releasees harmless, from and against any claim, cause of action, loss, liability, expense or damage of any kind (including reasonable attorney fees) incurred by Releasees on account of: (i) Recipient’s participation in the Program, (ii) injury to Recipient for any reason, (iii) a third party claim directly or indirectly arising out of, due to or in connection with Recipient’s negligence or intentional misconduct under this Agreement, or (iv) the negligence or willful misconduct of anyone for which Recipient is liable; except to the extent any of the foregoing is directly caused by the gross negligence or willful misconduct of Tulsa Remote. 

11. LIMITATION OF LIABILITY

RECIPIENT IS RESPONSIBLE FOR HIS/HER/THEIR OWN BELONGINGS AND ACTIONS. TULSA REMOTE SHALL NOT BE LIABLE TO RECIPIENT, IN RESPECT OF ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL OR CONSEQUENTIAL DAMAGES, OR LOSSES OR LIABILITIES OF ANY KIND OR NATURE, ARISING OUT OF THIS AGREEMENT, INCLUDING, WITHOUT LIMITATION THAT WHICH IS BASED ON THE LOCATION OR CONDITION OF ANY CO-WORKING SPACE, PERSONAL INJURY OR ILLNESS REGARDLESS OF THE CAUSE OR CAUSES INCLUDING WITHOUT LIMITATION EXPOSURE TO HAZARDOUS MATERIAL; OR DAMAGE, DESTRUCTION OR THEFT OF RECIPIENT’S PERSONAL PROPERTY, WHEREVER LOCATED, DUE TO ACTIONS OR OMISSIONS OF A THIRD PARTY OR DUE TO ACTS OF GOD; WHETHER OR NOT TULSA REMOTE WAS ADVISED OF THE POSSIBILITY, OR KNEW OR HAS REASON TO KNOW OF SUCH DAMAGE OR LOSS AND WHETHER OR NOT SUCH DAMAGE OR LOSS WAS FORESEEABLE; PROVIDED THAT NOTWITHSTANDING THE FOREGOING, TULSA REMOTE SHALL BE RESPONSIBLE FOR ANY PERSONAL INJURY TO RECIPIENT TO THE EXTENT CAUSED BY TULSA REMOTE’S GROSS NEGLIGENCE OR INTENTIONAL MISCONDUCT. 

12. DRAFTED BY ALL PARTIES 

This Agreement, and all the provisions of this Agreement, shall be deemed drafted by all of the Parties hereto. 

13. FAIR MEANING

This Agreement shall not be interpreted strictly for or against any Party, but solely in accordance with the fair meaning of the provisions hereof to effectuate the purposes and intent of this Agreement. 

14. MODIFICATION

This Agreement may be amended or modified only in writing which has been signed by both Parties and which specifically references this Agreement. 

15. GOVERNING LAW

This Agreement is made and executed in Tulsa County, Oklahoma. This Agreement shall be subject to, and interpreted in accordance with, the laws (excluding conflict of law provisions) of the State of Oklahoma. 

16. JURISDICTION AND VENUE

Any cause of action for a breach or enforcement of, or a declaratory judgment respecting, this Agreement shall be commenced and maintained only in the United States District Court for the Northern District of Oklahoma or, if there is not federal jurisdiction, the applicable Oklahoma state trial court sitting in Tulsa, Oklahoma and having subject matter jurisdiction. 

17. COUNTERPARTS

This Agreement may be signed in counterparts, each of which shall be deemed an original. This Agreement shall become effective only when each of the Parties hereto shall have signed the original or counterpart hereof. This Agreement may be signed and delivered by a facsimile or digitized transmission of a counterpart signature page. 

18. NO ADDITIONAL WARRANTY

Each Party hereto has entered into this Agreement based solely upon the agreements, any representations and warranties expressly set forth herein and upon her, his or its own knowledge and investigation. No Party has relied upon any representation or warranty of any other Party hereto except any such representations or warranties as are expressly set forth herein. 

19. ATTORNEY’S FEES

In any action brought by a Party hereto to enforce the obligations of any other Party hereto, the prevailing Party shall be entitled to collect from the opposing Party to such action such Party’s reasonable litigation costs and attorneys’ fees and expenses (including court costs, reasonable fees of accountants and experts, and other expenses incidental to the litigation). 

20. NO ASSIGNMENT

This Agreement may not be assigned (including performance by subcontract) by any Recipient. 

21. NO THIRD-PARTY BENEFICIARIES

This is not a third-party beneficiary contract except as to Releasees. No person or entity other than a Party signing this Agreement and the Releasees shall have any rights under this Agreement. 

22. INDEPENDENT CONTRACTORS

This is not a contract for the performance of work or services. Nothing in this Agreement shall be construed to create a partnership, employment relationship, or joint venture, nor to authorize any Party hereto to act as agent for or representative of any other Party hereto. Each Party hereto shall be deemed an independent contractor and no Party hereto shall act as, or hold itself out as acting as, agent for any other Party hereto. 

23. NO WAIVER

A Party to this Agreement may decide or fail to require full or timely performance of any obligation arising under this Agreement. The decision or failure of a Party hereto to require full or timely performance of any obligation arising under this Agreement (whether on a single occasion or on multiple occasions) shall not be deemed a waiver of any such obligation. No such decisions or failures shall give rise to any claim of estoppel, laches, course of dealing, amendment of this Agreement by course of dealing, or other defense of any nature to any obligation arising hereunder. 

24. SEVERABILITY

In the event any provision of this Agreement, or the application of such provision to any person or set of circumstances, shall be determined to be invalid, unlawful, or unenforceable to any extent for any reason, the remainder of this Agreement, and the application of such provision to persons or circumstances other than those as to which it is determined to be invalid, unlawful, or unenforceable, shall not be affected and shall continue to be enforceable to the fullest extent permitted by law. 

25. CHANGES

Tulsa Remote may update, amend, or rescind any provision of the website Terms of Use and to make such other rules and regulations (together “Changes”) as in Tulsa Remote’s judgment shall, from time to time, be necessary or desirable for the safety, protection, care of the Program, and for the protection and comfort of all Recipients. Postings by Tulsa Remote on its website regarding Changes shall be effective immediately. 

26. ENTIRE AGREEMENT

This Agreement is the entire Agreement of the Parties respecting the subject matter hereof. There are no other agreements, representations or warranties, whether oral or written, respecting the subject matter hereof. 

[Signature Page Follows]

IN WITNESS WHEREOF, the Agreement has been executed and delivered as of the Effective Date.  

EFFECTIVE DATE: ___________________

TULSA REMOTE, LLC

(“TULSA REMOTE”)  

Signature: ___________________

Printed Name: Justin Harlan

Title: Managing Director

Date:  ___________________

RECIPIENT

Signature:___________________

Printed Full Name: ___________________

Date: ___________________

Program Term: 12 Months  

 

EMERGENCY CONTACTS and PERMISSION TO CONTACT

Though Program Recipients are wholly responsible for themselves, Tulsa Remote is willing to maintain emergency contact information for Program Recipients so that Tulsa Remote might be of assistance in the event of a tragedy or disaster. 

By providing information below, Recipient acknowledges that Tulsa Remote has no obligation to make emergency contacts and no liability for making emergency contacts and/or providing information to emergency contacts, but grants permission for Tulsa Remote to voluntarily make such contacts and to provide such information as Tulsa Remote deems reasonable. 

Recipient Contact Information:
First Name Last Name
Mobile Phone
Email
City of Tulsa Recipient Occupied Address
Street Address
City, State
Zip

In case of emergency, Tulsa Remote has my permission to contact the following emergency contacts and share information about me: 

Emergency Contact Name:

Emergency Contact Phone Number:

Recipient Signature for Authorization:

Signature Date:

Recipient Printed Name:

Recipient Signature:  

 

PHOTOGRAPH AND MEDIA RELEASE

AND WAIVER

This Exhibit A, Photograph and Media Release and Waiver (“Release”), is attached to, subject to and made a part of that certain Agreement (the “Agreement”) by and between Tulsa Remote, LLC (“Tulsa Remote”) and the Recipient named on the Agreement (“Recipient”, “I”, “me” or “myself”). 

I, the undersigned Recipient, hereby give my permission for Tulsa Remote and/or its agent to photograph, film, record, videotape, make sound recordings, broadcast and/or stream (including without limitation Facebook Live) of me, or otherwise capture my likeness while I am in public places or engaged in public activities, Community Touchpoint activities, and, to quote me or record my statements about Program. Tulsa Remote, the Program (the foregoing all together called “Likenesses”, referenced herein as the “Released Likenesses”). The Released Likenesses may be used or reused, published or republished, modified or altered, in perpetuity, for the sole and exclusive purposes of promoting my accomplishments, my presence and my participation in the Program as well as for educating, promoting and advertising of the Program to the community and other Recipients. I understand that I may be identified in any photographs, news stories or publications that Tulsa Remote considers appropriate for release to magazines, newspapers, the World Wide Web sites of Tulsa Remote, and/or other publication(s) in any form now existing or later developed. I further understand that the Likenesses are the property of Tulsa Remote and that I have no right to money for the Likenesses. I understand that I have the right solely to have use the Likenesses, except as Tulsa Remote may otherwise agree, in writing, for marketing purposes. I, on behalf of myself and my heirs, assigns, and personal representatives, and anyone claiming on behalf of or through any of the foregoing, irrevocably and unconditionally waive, release, acquit, forgive and forever discharge Tulsa Remote and its predecessors, successors and assigns, and its and their officers, directors, managers, employees, agents, representatives, attorneys and insurers (together the “Releasees ”) from any and all claims which I may now or in the future have against any of the Releasees, based upon, due to, arising out of or in any way connected with or pertaining to the matters covered by this Photograph and Media Release and Waiver, from the beginning of time through the end of time. 

Recipient Signature for Release and Waiver:

Signature Date:

Recipient Printed Name:

Recipient Signature:  

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