Publicity Release Form

PUBLICITY RELEASE FORM

I confirm that I give permission to SP Health Co Pty Ltd ABN 73 123 248 046and its related companies (together “SP Health”),who are the managers of the CSIRO Total Wellbeing Diet, to use my name, any still and video images and/or audio, as well as any relevant personal information gathered as part of a promotional interview given by me (together “Materials”) as set out in this Form.

Platform / Total Wellbeing Diet
Territory / Worldwide
Time Period / 3 years from date of signature
Type of Usage / Total Wellbeing Diet website, digital, PR, print and social advertising

In addition to the rights granted above, I confirm that Igive permission to SP Health to use the Materials:

(a)On the websites associated with the Total Wellbeing Diet;

(b)In print, online, digital and television advertising for the Total Wellbeing Diet; and

(c)For publicity purposes for the Total Wellbeing Diet.

I confirm my understanding that:

(i)SP Health will send the Materials to me for me to approve any aspect of the Materials that relate specifically to me;

(ii)If I don’t respond to SP Health within 48 hours of SP Health sending the Materials to me for approval, my approval will be deemed to be given;

(iii)The use of the Materials bySP Health is undertaken without any form of considerationto me; and

(ii)My remedies in relation to this releaseare limited to the right to recover damages at law. Under no circumstances am I entitled to rescind any permission given in this releaseor, revoke the rights granted under this release, or seek any injunction against SP Health.

I acknowledge that I have read and understood this release form.

Print Name: ______

Address: ______

Contact phone number: ______

Signature:Date:

Level 1, 65 Walker Street, North Sydney, NSW 2060, Tel: +61 2 9923 8222, Fax:+61 2 9923 8223

ABN: 73 123 248 046