RELEASE and AUTHORIZATION to
PHOTOGRAPH or OTHERWISE RECORD

I, the undersigned, do hereby consent to being photographed or otherwise recorded by__________________________________ ,

or any of its affiliates, and I also give______________________________________, permission to put the finished photographs,

films, or videotapes, to any legitimate uses it may deem proper. Further, I hereby relinquish and give

to ________________________________, all right, title and interest I may have in the finished pictures, negatives, reproductions

and copies of the original prints and negatives, and further grant__________________________________ the right to give,

sell, transfer and exhibit the negatives, original prints or copies and facsimiles thereof to any individual, business firm,

or publication or to any of their assignees and to circulate the same for any and all purposes and in any manner,

including publications and advertisements of all kinds in all media. I, the undersigned, do hereby further agree and acknowledge

that I have not, and will not claim to have, either under this agreement or otherwise, any right, copyright, title, or interest of

any kind or nature whatsoever, in and to any program of films or videotapes taken by___________________________________,

in which I appear, including but not limited to the scripts, title, copyright, ideas, names, theses and / or the other characteristics

and incidents of any such program of_________________________________, its successors, agents, licenses, customers and assigns.

I further hereby release___________________________________________ , its associates, successors and assignees, from any

and all claims for damages for libel, slander, invasion of the right of privacy, or any other claim based on the use of said material.

This release is made on behalf of myself, my heirs, executors, administrators and assigns, and is to be governed by the

laws of the State of California .

Signature______________________________________

Date________________________________________

Witness_________________________________________