MAKE YOUR FREE Video Clearance

VIDEO CLEARANCE

Effective as of the date shown below, approval for past use and permission for present and future use is being granted to of , , , , to use a picture or voice recording of . Permission is being given by the undersigned, (the "Recorded Party"), as more fully explained in this Video Clearance. The undersigned is an adult and fully authorized to sign this Video Clearance.

receipt of which is hereby acknowledged, the undersigned hereby grants to its agents, employees, licensees, and successors in interest (collectively, the "Released Party") all ownership rights and the absolute and irrevocable right and permission to copyright, use and publish the recorded image and/or voice of (the "Image and/or Voice") that has been (or is being) obtained pursuant to this Video Clearance.

The Image and/or Voice may be copyrighted, used and/or published individually or in conjunction with other photography, video works, and recordings, and in any medium (including without limitation, print publications, public broadcast, CD-ROM format) and for any lawful purpose, including without limitation, trade, exhibition, illustration, promotion, publicity, advertising and electronic publication.

The undersigned represents and warrants that (i) no other party has been granted an exclusive license with respect to the Image and/or Voice, and (ii) no other party's authorization or consent is required with respect to the permission granted to the Released Party under this Video Clearance.

The undersigned waives any right that the undersigned may have to inspect or approve the Released Party's use of the Image and/or Voice, or the advertising copy or printed matter that may be used in connection with the use and/or publication of the Image and/or Voice. The undersigned releases the Released Party (and all persons acting under its permission or authority) from all claims for libel, slander, invasion of privacy, infringement of copyright or right of publicity, or any other claim related to the Image and/or Voice (collectively, "Claims"). This release includes without limitation any Claims related to blurring, distortion, alteration, optical illusion, digital alteration, use in composite form, whether intentional or otherwise, or use of a fictitious name, that may occur or be produced in the processing or publication of the Image and/or Voice.

THE UNDERSIGNED WARRANTS THAT THE UNDERSIGNED HAS READ THIS VIDEO CLEARANCE PRIOR TO THE SIGNING OF THIS DOCUMENT, THAT THE UNDERSIGNED UNDERSTANDS IT, AND THAT THE UNDERSIGNED FREELY ENTERS INTO THIS VIDEO CLEARANCE.

Date:

,