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I, of , , , (The "Subject"), for good and valuable consideration, hereby give permission to of , , , and/or parties designated by to photograph myself and use such photographs in all forms of media, for any and all promotional purposes including advertising, publicity, display, audiovisual, exhibition, commercial or editorial use.

I understand that the term "photograph" as used herein encompasses still photographs, audio recording and motion picture footage.

I further consent to the reproduction and/or authorization by to reproduce and use such photographs for use in all domestic and foreign markets.

I hereby release and any associates, affiliates, appointed advertising agencies and designated directors, officers, agents, employees and customers from any claims.

I further waive any and all rights to review or approve any use of the photograph within any written copy or finished product.

Subject is a minor or legally incapable to give consent. The below representative provides consent for the witness and consents with all the responsibilities and terms within this form:

Print Name:___________________________
Relationship to Subject:___________________________
Date: ___________________________

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