Minor Release

In consideration of________________________________________, and for other good and valuable consideration herein acknowledged as received and sufficient, upon the terms hereinafter stated, I hereby grant to ____________________________ ("Publisher"), his/her legal representatives and assigns, those for whom Publisher is acting, and those acting with his/her authority and permission, the absolute, irrevocable and unrestricted right and permission to use, re-use, reproduce, publish, and re-publish photographic portraits or pictures of the minor or in which the minor may be included, in whole or in part, or composite or distorted in character or form, without restriction as to changes or alterations, in conjunction with the minor's own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium at his/her studios or elsewhere, and in any and all media now or hereafter known, for art, advertising trade or any other purpose whatsoever. I also consent to the use of any printed matter in conjunction therewith. I hereby waive any right that I or the minor my have to inspect or approve the finished product or products or the advertising copy or printed matter that may be used in connection therewith or the use to which it may be applied. I hereby release, discharge, and agree to save harmless Publisher, his/her heirs, legal representatives and assigns, and all persons acting under his/her permission or authority or those for whom he/she is acting, from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, ,vhether intentional or otherwise, that may occur or be produced in the taking of said picture or in any subsequent processing thereof, as well as any use, reproduction or publication thereof, including without limitation any claims for libel or invasion of privacy. I hereby warrant that I am of full age and have every right to contract for the minor in the above regard. I state further that I have read the above authorization, release, and agreement, prior to its execution, and that I am fully familiar with the contents thereof This release shall be binding upon the minor and me and the minor's and my heirs, legal representatives, and assigns.

SIGNATURE_________________________________ PRINTED NAME_______________________________ DATE_______________________________________ ADDRESS___________________________________ ____________________________________________ ____________________________________________

WITNESS SIGNATURE__________________________ PRINTED NAME________________________________ DATE_________________________________________ ADDRESS_____________________________________ ______________________________________________ ______________________________________________