Fill and Sign the Authorization to Photograph and Waiver or Release of Form

Authorization to Photograph and Waiver of Liability for Damages to Person or PropertyRelease executed on ______________________ (date), by ________________________ (Name) of _____________________________________________________________________ ____________________________________ (street address, city, county, state, zip code) herein referred to as Releasor, in favor of _________________________________________ (Name of Company), a corporation organized and existing under the laws of the state of ______________________, with its principal office located at ___________________________ ______________________________________________________________________________ (street address, city, county, state, zip code) , referred to herein as of ______________________ ______________________________________________________________________________ (street address, city, county, state, zip code) herein referred to as Releasee.Whereas, Releasor shall participate in a photo shoot on __________________________ (date); and Whereas, Releasee requires the execution this Authorization and Waiver in order to be allowed to participate is said photo shoot; Now, therefore, for and in consideration of the sum of Ten Dollars ($10.00), and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, Releasor agrees to the following:1.Releasor consents to being the subject of photographs of Releasor together with any subject matter owned by Releasor, and hereby authorizes Releasee to cause the same to be exhibited, with or without advertising sponsorship, as still photographs, transparencies, motion pictures, television, video or other similar media.2.Releasor hereby releases Releasee, and any associates, as well as any assignees, from any and all claims for damages for libel, slander, invasion of privacy or any other claim based on use of the above-described material(s).3. Releasor further releases Releasee and any associates, as well as any assignees, from any and all claims for damages. Releasor understands that the activities he/she that will participate in can be dangerous and may cause serious or grievous injuries, including bodily injury, property damage, and/or death. The undersigned Releasor waives all claims for damages (including damages to my person as well as property damages), injuries and death sustained by me that he/she may have or acquire against Releasees regarding any such activities. In witness whereof, Releasor has executed this Authorization and Waiver on the day and year first above written.________________________________ _______________________________WitnessReleasor