To request permission to use a video, written, or audio story or PSA from the Shot by Shot storybank collection (“SBS Story”):
Please list the name(s) of the SBS Story (or Stories) you would like to use.Note: For permission to use the stories with asterisks (*), please contact the originating organization directly.
Please describe the planned date(s) of use and how you will use a SBS Story (Stories), e.g., training medical assistants, Toddler Immunization Month event for the public, post on your organization’s website (include url).
In order to process your request, you must agree that Shot by Shot Stories will be used only in accordance with the mission of the California Immunization Coalition.
Check the 10 boxes below to confirm your agreement (“I/We” refers to both myself and the below listed organization):
I/WE will use SBS Stories only in accordance with the California Immunization Coalition’s mission.
I/WE will not edit or alter any SBS Story.
I/WE will not sell or make a profit from using any SBS Story.
I/WE will not transfer copies of any SBS Story to any individual or entity without the express, written permission of the CIC.
I/WE will use SBS Stories only for educational or information purposes (e.g., in a classroom, community program, training, outreach event, professional conference, media report, or personal or family use).
I/WE understand and agree that any permission I/WE receive from SBS may be revoked by SBS, without cause, upon notice sent to me via the email address provided below. Immediately upon SBS's dispatch of such a revocation notice, I/WE will stop all uses of any SBS Stories, including without limitation, removing them from websites.
I am authorized to enter into this agreement on behalf of the below listed organization (if any), and both I and said organization will be bound by this agreement.
I/We understand and agree that CIC and SBS do not vouch for or guarantee the accuracy of the information or statements made in the SBS Story, nor that they may be used without violating copyright, trade secret, privacy and other laws (or rights of third parties). I/We assume all risk for any use we make of said SBS Story (Stories), and waive all claims, damages and causes of action that I/We may come to have against CIC and/or SBS, including without limitation, claims for indemnity. I/We understand that it is our responsibility to verify that such stories may be used without violating applicable laws or rights of third parties.
I/We agree that, no lawsuit may be filed or heard relating to this agreement, concerning the subject matter thereof, or seeking to enforce the terms thereof, except before the State and Federal Courts located in Sacramento, California, and I/We hereby submit to the personal jurisdiction of such Courts.
I/WE understand that by checking this box and submitting this form electronically, a binding legal contract is being formed.
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