Fill and Sign the Photograph Waiver Form

Authorization to Photograph and Waiver of Liability for Damages to Person or Property Release 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 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; Whereas, Releasor is a minor and _____________________________ (Name) is the __________________________________ (Parent or Guardian) of Releasor and Whereas, Releasor and _________________________________ (Name of Parent or Guardian) are hereinafter jointly and severally referred to as Releasors; 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, Releasors agrees to the following: 1. Releasors consents to _______________________________ (Name of Minor) being the subject of photographs of Releasee , together with any subject matter owned by Releasors , 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. Releasors 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. Releasors further releases Releasee and any associates, as well as any assignees, from any and all claims for damages. Releasors understand 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 Releasors waive all claims for damages (including damages to my person as well as property damages), injuries and death sustained by ______________________ (Name of Minor) that he/she may have or acquire against Releasee or any agent or employee of Releasee regarding any such activities. The undersigned _______________________________ (Parent or Guardian) does hereby agree to indemnify, hold harmless and forever discharge Releasee and/or Releasee’s agents and employees from any loss, liability, attorneys’ fees, damage, or costs that Releasee or the agent or employees of Releasor may incur arising out of or related to the said photo shoot of ________________________________ (Name of Minor) , whether caused by the negligence of the Releasee or otherwise. In witness whereof, Releasors have executed this Authorization and Waiver on the day and year first above written. ___________________________________ ___________________________________ Witness Releasor (Minor) ___________________________________ ___________________________________ Releasor (Parent or Guardian) Witness