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Share Your Story
Do you or someone you know have an amazing story of survival?
If you or someone you know would like to be considered for participation on I Survived..., please fill out the form below. The information you provide will be submitted to the production team that produces I Survived... for A&E Television Networks (AETN). By submitting this information, you give the right to use the information below in connection with the I Survived... television program.
Have you or someone you know had a near death experience?
The producers of I Survived... are seeking people who technically died or flat-lined during a medical or accident emergency, had inexplicable experiences during this time, and then came back to life -- and who would like to share those experiences with a television audience. The information you provide will be submitted to the production team that produces I Survived... Beyond and Back for A&E Television Networks (AETN). By submitting this information, you give the right to use the information below in connection with the I Survived... Beyond and Back television program.
You acknowledge that you may not receive a response from this submission.
If you are chosen to participate you will be required to sign appropriate releases.
All fields are required unless otherwise noted.
Submission Release Agreement
You wish to submit to producers of a certain television program on BIO (“Producer”) certain information and/or materials, including but not limited to, ideas, concepts, proposals, marketing or promotional plans, program formats, talent, literary materials, scripts, video, musical compositions and other suggestions (the “Material”). By submitting Material to Producer You agree to the following submission release terms and conditions (“Release”):
1. The terms “You” and “Your” include and bind the undersigned and any and all legal representatives of the undersigned releaser, its successors, assigns, heirs, employees, co-creators, co-producers, joint-authors, officers, directors, licensees, agencies, agents, and associated companies and individuals. As used in this Release, the terms “Producer” and “we” includes and inures to the benefit of Producer and its successors, assigns, employees, parents, subsidiaries, joint ventures, affiliates, agents, business associates, insurers, officers, directors, licensees, and associated companies and individuals.
2. Producer shall have the right (but not the obligation) to cause its employee(s) and/or agent(s) to review the Material. You agree that the possibility of having Producer review and consider Your Material is good and valuable consideration for this Agreement.
3. You agree that neither Your submission of Materials, nor Producer’s receipt, or review, of the Materials, creates any confidential or fiduciary relationship of any type between You and Producer.
4. You acknowledge and agree that no agreement exists between You and Producer, whether written or oral, concerning the use of the Material and that no obligation of any kind is assumed by, or may be implied against, Producer unless and until a formal written contract has been signed by both You and Producer, and then the obligations shall be only as expressed in such executed written agreement. Producer’s review of Your Material constitutes Producer’s acceptance of the terms and conditions set forth herein, and Producer shall have relied upon Your agreement herein in considering Your Material for review.
5. You acknowledge that this Agreement covers and governs any and all of the Material, whether submitted to Producer contemporaneously with, prior to, or following, the execution of this Agreement, and applies also to any and all submission of Material made to Producer by any other source, directly or indirectly, written or orally, on Your behalf for a period of five (5) years from the date of this Agreement.
6. You warrant that You are the sole and exclusive creator, author and owner of the Material (or, if the Material is a joint work, all contributors have been concurrently disclosed by You, and You have the authority to act on their behalf), and that no one else has any right to the Material. You further warrant that no rights in the Material have previously been granted to anyone, nor has the Material otherwise been exploited in any way.
7. You agree that Producer’s receipt of Your Material does not constitute, imply, or provide any evidence that Producer regards Your Material, or any part thereof, as novel, valuable or usable. You recognize that other persons, including Producer employees, may have submitted to Producer (or to others), or made public, or may hereafter originate, submit, or make public, similar or identical material, and you acknowledge and understand that you will not be entitled to any compensation because of Producer’s use of such other similar or identical material.
8. You agree that any controversy arising out of or in connection with this Agreement, or arising out of or in connection with any submission of Materials to Producer, shall be governed by the laws of the State of New York, and You consent to the jurisdiction of the state and federal courts of New York located in New York County for the resolution of such matters. If such a controversy arises, you agree that you shall assert such claims not later than six (6) months after the date on which you first learned of Producer’s use or intended use of any legally protectable portion of the Material. You further agree that Your rights and remedies, if any, shall be limited to an action to recover money damages in an action at law, and without limitation of the foregoing, you expressly agree that you shall not seek to enjoin or restrain the production, exhibition, distribution, licensing, advertising, and/or promotion of any of Producer’s programming, promotional or marketing plans, and/or of the subsidiary rights in connection therewith. You further agree that the only potential monetary recovery which you are entitled to will be no greater than compensation ordinarily paid by Producer for similar Material from comparable sources.
9. This Agreement constitutes the entire understanding and agreement between You and Producer, and supersedes all prior understandings or agreements, whether written or orally made to Producer regarding any Materials presented to Producer during the term of this Agreement. Any subsequent modification or waiver of this Agreement must be in writing, signed by both Parties. The invalidity of any provision hereof shall not affect the remaining provisions.
10. You acknowledge that You are executing this Release voluntarily, without coercion or undue influence from any source, and do so with complete understanding of all its terms and effects, and every portion thereof. You further represent and warrant that You have the authority to make this Agreement with Producer. If it is determined that You did not possess the authority to make this Agreement with Producer, You agree to indemnify Producer for any losses or legal expenses incurred and/or any verdicts against Producer.
By signing below, you hereby certify that You: (i) have read the Producer policy concerning the acceptance of the Material for review, (ii) accept the terms of this Agreement (iii) represent that You have the complete power and authority to act on behalf of Yourself, Your company, or client and can thereby bind Your company or client to the terms of this Agreement, and (iv) agree and acknowledge that acceptance of this Agreement will hereby apply to all current as well as any future Materials; and, in exchange for Producer’s willingness to consider Your Materials, You also agree that this Agreement applies to any Material previously submitted by You to Producer regardless of whether the previous Material was submitted under the same version of this Agreement or without any Agreement at all.
Upcoming Schedule
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Sunday, June 2 @ 9:00PM New
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Monday, June 3 @ 1:00AM

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