“Selected location above” would like to use and publicize the name, likeness, and other personal characteristics of (“Model”) in exchange for the intangible value he/she will gain by participating in the Company’s publicity programs.

I provide consent for participation in the Company’s publicity programs. I acknowledge and agree that I am responsible for the safety during the photo shoot. No additional consent or authorization is required for this document to be effective.

In exchange for good and valuable consideration I acknowledge has been received, I hereby grant Company and its affiliates, successors and assigns an irrevocable, perpetual and unrestricted right and permission to take, use, re-use, publish, and republish photographic portraits, pictures, video or other images of Model (“Images”). I further transfer and assign to the Company all right, title and interest, if any, to all copyrights related to the Images.

I understand and agree Company may change or alter the Images without restriction, use the Images in whole or composite, and the Images may be distributed through any type of media existing now or in the future, including without limitation in print media and on the Internet . I further understand and agree the Images may be used for advertising, public relations, promotion, art, commercial or other purposes. Finally, I understand and agree that any uses of the Images will be made by the Company without further consent from or compensation to me or Model.

I hereby release and discharge the Company and its affiliates from any and all claims and demands that may arise out of or in connection with the taking or the use of the Images, including without limitation any and all claims for libel or violation of any right of publicity or privacy.