Location Application For Student Athletes

Location Application For Student Athletes

Instructions: A student athlete looking to conduct name, image, likeness filming or photography on campus in connection with any third-party, such as an agent or production company, must fill out the form below at least 30 days prior to the third-party’s first day on site and submit it to the division of Communications and Marketing. This agreement is for use by Production Companies working in affiliation with Vanderbilt student-athletes only. No filming or photography will be permitted pursuant to this application without the involvement of a Vanderbilt student-athlete. Access to campus by third parties is strictly limited.
Type of Project:

Type of Project: Film Video Photo
Project Title:
Production Company:
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Production Manager/Coordinator:
Email:
Phone Phone - ### - ### ####
Set-up/Strike Date(s):
Shoot Date(s):
Hours Requested:
Number of Cast/Crew:
Location(s) Requested:
Special Service Needs (electrical, security, catering, on-campus parking, etc.):
Use of Vanderbilt Premises: All film, video, or photograph production must occur on campus grounds available to the general public. Film, video, photograph production within Vanderbilt’s facilities and buildings is prohibited. Notwithstanding the preceding sentence, if Vanderbilt’s premises are identifiable in the footage, then Production Company must obtain written approval from Vanderbilt prior to any such exhibition, advertising, or promotion. A Vanderbilt staff member must accompany anyone who is not directly affiliated with Vanderbilt while on campus at all times.

Expenses: Direct expenses incurred by Vanderbilt in the performance of this Agreement, including, but not limited to, fees for Traffic and Parking personnel, Vanderbilt University Police personnel, Schedules and Reservations services, and Plant Operations services, may be charged to Production Company, if necessary.

Use of Name: Production Company agrees it shall not use Vanderbilt’s name or distinguishing marks or logos in any publication or film, video, or media product.

Insurance Requirements: Production Company must be able to provide no less than $2,000,000 of general liability insurance with limits of $2,000,000 per occurrence, no less than $1,000,000 of auto liability insurance, and if Production Company employs five or more persons, proof of worker's compensation insurance. Please provide a certificate of insurance that lists Vanderbilt University as an additional insured and evidences the existence and amounts of such insurance to Vanderbilt before using the premises. If you cannot meet this requirement, what liability amount(s) do you have?
Specific Details of Project (e.g., purpose, how content will be used, where project will be featured):
Please check each box to show that you understand and agree to the following terms:

Please check each box to show that you understand and agree to the following terms: The production contemplated by this Application must be permitted by Tennessee’s name, image, likeness statute, T.C.A. § 49-7-2801, et. seq. Any substantive change in the above information will require resubmission of application. If the film or video box is checked, the completed application should be accompanied by a copy of the script/storyboard with the scene(s) to be shot at Vanderbilt highlighted. If the photo(s) will be used commercially, a rough layout of the proposed ad or printed collateral showing the specific text that will be associated with any image(s) of the Vanderbilt campus must be submitted. The use of the Vanderbilt premises is for location only. Vanderbilt University shall not be recognizable in the film, video or photography without the permission of the Division of Communications. Production company will adhere to Vanderbilt’s protection of minors policy and perform background checks on all personnel on our premises. Production company will accept full responsibility to Vanderbilt for the acts and omissions of all persons, whether directly or indirectly employed, while on campus. If granted permission to access university locations, I must execute a location agreement, provide a certificate of insurance and pay any applicable fees before production may begin. I have read and understand these guidelines and agree to the requirements set forth in this document.
Please submit completed application at least 30 calendar days prior to your first prep or shoot day. Based on your responses, Vanderbilt will contact you with a Location Agreement that must be executed prior to your first day on campus.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
SUBMISSION OF THIS APPLICATION IS NOT APPROVAL. ALL APPLICATIONS WILL BE REVIEWED IN THE ORDER THEY ARE RECEIVED. PROJECTS MUST BE APPROVED BY VANDERBILT’S ATHLETICS AND DIVISION OF COMMUNICATIONS AND MARKETING BEFORE PRODUCTION BEGINS.