I-SEE-YOU CONTENT SUBMISSION EXCLUSIVE RELEASE AND GRANT OF RIGHTS

Similar documents
AMERICA S FUNNIEST HOME VIDEOS PERSONAL RELEASE AND GRANT OF RIGHTS (Version 11/20/09)

TO BE SIGNED BY PERSON(S) WHO APPEAR AND/OR WHOSE VOICE CAN BE HEARD IN VIDEO

LOST RELEASE AND GRANT OF RIGHTS. I/we am/are at least 18 years of age or the age of majority in my/our state of domicile (if higher).

GENERAL APPEARANCE RELEASE FORM

LATIN TALENT SEARCH WAIVER OF LIABILITY, PERSONAL RELEASE AND CONSENT FORM

Screen Option Example

168 FILM PROJECT 2017 OFFICIAL ENTRY AGREEMENT [Updated April 8, 2017] Team # Film Type. Entrant Name. Address: Apt/Suite

AGREEMENT FOR NON-WRITING SERVICES

DO NOT SIGN UNTIL YOU HAVE COMPLETELY READ THIS RELEASE IN ITS ENTIRETY AMERICAN IDOL SEASON 11 PERSONAL RELEASE In full and complete consideration

The Windsor International Film Festival Corporation s 48-Hour FlickFest package contains the following:

SYNCHRONIZATION LICENSE AGREEMENT

HARD ROCK S AMBASSADORS OF ROCK BATTLE OF THE BANDS ENTRY FORM

YOGA WAKE UP YOGA TEACHER AGREEMENT DATE: NOTICES AND PAYMENTS TO: Phone:

SHARK TANK INITIAL APPLICATION PACKET

Agree to Terms & Conditions

OFFICIAL ENTRY FORM ENTRY FEE: $250 / DEADLINE FRIDAY, SEPTEMBER 7 / 5PM PST. Estimated Competition Weight: Height: Age:

PARTICIPATION AGREEMENT

Now, therefore, the parties listed, intending to be legally bound, hereby agree as follows:

ilicensemusic 454 Las Gallinas Ave, suite #142 San Rafael, California (510)

SCARY MOVIE PRODUCTIONS, L.L.C. 555 Director s Chair Ave. # 4000 Hollywood, California 90028

on the order date (and time) the beat title (of the order) License Fee: Delivery of the Beat: Term: Use of the Beat: non-exclusive, nontransferable

DUETS ELIGIBILITY REQUIREMENTS AND APPLICANT QUESTIONNAIRE ELIGIBILITY REQUIREMENTS

SUBMISSION AGREEMENT

ARTS N EDUCATION PROGRAM PERFORMING ARTS CLASSES

Broadcast Music, Inc., 7 World Trade Center, 250 Greenwich St., New York, NY Date:

SAMPLE. THEREFORE, in consideration of the mutual agreements herein contained, it is agreed as follows:

IF WE ARE INTERESTED OR HAVE MORE QUESTIONS ABOUT YOUR FAMILY AND/OR SITUATION, WE WILL CALL YOU. IT COULD BE SEVERAL MONTHS BEFORE YOU HEAR FROM US!

Antenna Music Exclusive Placement Agreement

HOMER FUND: Homer bobble head DESIGN CONTEST GUIDELINES

Ford Lincoln of Queens NY1 Scholar Athlete of the Week Nomination Form

LET S MAKE A DEAL CONTESTANT SEARCH 2017 ELIGIBILITY REQUIREMENTS

Airtime Purchase. INSP Airtime Purchase. Inventory Ownership. Submission of Short and Long Form Material. Terms & Conditions Definitions

Contestant Application

CONSIGNMENT AGREEMENT The Golden Closet 7243 Coldwater Canyon Avenue North Hollywood, CA 91605

Qualified Escrow Agreement

ASSUMPTION OF RISK, RELEASE AND LIABILITY WAIVER

AGE FOTOSTOCK SPAIN, S.L. NON-EXCLUSIVE PHOTOGRAPHER AGREEMENT FOR RIGHTS MANAGED LICENSING

AMY SEELEY MUSIC MUSIC LICENSE AGREEMENT - INTERNET/WEBSITE

RELEASE AND WAIVER OF LIABILITY Sports Authority Football Field Day

SCREENWRITERS' COLLABORATION AGREEMENT

Copyright Wars and the Music Industry Fall 2006 Prof. Peter Yu. Problem Set 3

USTOCKTRAIN TRADING SIMULATOR TERMS AND CONDITIONS

PARTICIPANT APPLICATION & RELEASE WEIGHT LOSS SHOW

SAMPLE DOCUMENT. Date: Type: History Museum. Accredited: [Choose Accreditation Status] USE STATEMENT & COPYRIGHT NOTICE

NASCAR Angels Season Two: Selected Metropolitan Areas and Application Deadlines

Terms & Conditions of Entry (the Official Rules )

OFFICIAL RULES TO SUBMIT

Incarnate Gaming LICENSE AND DISTRIBUTION AGREEMENT

Firehouse Subs #FuelUnder500 Sweepstakes OFFICIAL RULES

NASCAR Angels Season Two: Selected Metropolitan Areas and Application Deadlines

ACCESS AGREEMENT WAIVER AND RELEASE REQUIRED

PARENTAL CONFIRMATION AGREEMENT

The Guild, Inc. ARTWORK PUBLISHING AGREEMENT

PUBLISHING AGREEMENT. In consideration of the mutual covenants herein contained, the parties agree as follows: SAMPLE

STANDARD TERMS AND CONDITIONS FOR PURCHASE/PLACEMENT OF ADVERTISING AND ASSOCIATED PRODUCTION SERVICES

In this Agreement the following terms shall have the following meanings

APA Releases. Advertising Photographers of America

License Agreement. Materials: Script (as PDF); Conductor/Key/Vocal Score (5 books/folders); Full Score, Parts (5 books/folders)

If you are selected as the winner, please return all pages of this signed Agreement by fax to +44(0)

2016 WOMEN S FINAL FOUR EMCEE SERACH. Full Name. Birthdate. Address. Name of Uploaded Video

THE PRICE IS RIGHT CONTESTANT SEARCH JACKSON RANCHERIA CASINO RESORT SEPTEMBER 25, 2015 PARTICIPANT APPLICATION

THESE TERMS CONTAIN IMPORTANT INFORMATION ABOUT YOUR RIGHTS, PRIVACY AND PERSONAL INFORMATION. PLEASE READ THESE TERMS CAREFULLY.

MWC19 Barcelona Speaker Video Footage - Terms of Use

ENERCALC Software License Agreement

Volunteer Services Agreement

The ASCAP Foundation Official Awards General Rules and Regulations

MNG HEALTH Website Terms and Conditions

David B. Perry. Ricky's request to review the Dallas Police file on his father.

DESIGN THE TRASE SHOE FOR DC SHOES OFFICIAL RULES

ADVANCED ACCESS CONTENT SYSTEM ( AACS ) RESELLER AGREEMENT

OptBlue ISO and Agent Testimonial program Terms of Participation. Table of Contents

SERVICE REFERRAL AGREEMENT

Kiss Your Landlord Goodbye! Contest Official Rules

HDCP RESELLER ASSOCIATE AGREEMENT W I T N E S S E T H

VOYA 2016 ETHICS AWARENESS WEEK EMPLOYEE VIDEO CONTEST VIDEO SUBMISSION FORM

OTTO Archive, LLC CONTENT LICENSE AGREEMENT

PROPOSAL SUBMISSION AGREEMENT

THIS PAGE TO BE COMPLETED BY BMI. REMEMBER TO SIGN ON PAGE NINE.

Trademark License Agreement

~LOTUS GUNWORKS OF SOUTH FLORIDA, LLC~ RELEASE, WAIVER, INDEMNIFICATION, HOLD HARMLESS, AND ASSUMPTION OF THE RISK AGREEMENT

ARTIST MANAGEMENT CONTRACT

First Shipment Sweepstakes

LA OPERA "2019 PLÁCIDO DOMINGO AWARDS" SWEEPSTAKES

IF YOU DO NOT AGREE TO THE TERMS OF USE, YOU MAY NOT ACCESS OR USE THE SITE.

AUTHOR PUBLISHING AGREEMENT

Terms and Conditions I. CONTENT. Proprietary Rights

NON-TRANSFERABLE AND NON-EXCLUSIVE LICENSE AGREEMENT

Site Builder End User License Agreement

2018 Jr. Celtics Two-day Winter Break Clinic Registration Form

Firehouse Restaurant Group, Inc. Customer Survey Sweepstakes Official Rules

Virgin America Night VIP Sweepstakes January 22, 2014 through February 5, 2014 Official Rules

PROFESSIONAL SERVICES AGREEMENT

Digital Entertainment Content Ecosystem MEDIA FORMAT SPECIFICATION AGREEMENT FOR IMPLEMENTATION

AVSS/NET SOFTWARE AGREEMENT

SUMMER WINTER ACTION TOURS, LLC DBA SWAT SPRING BREAK 2015 SURVEY GIVEAWAY CONTEST (the Contest ) I do hereby declare that I, of,

DECORATE YOUR SPACE! MAY 2012 WINNER ASSIGNMENT AND RELEASE

I, ( I or Winner ), being duly sworn, depose and say:

TERMS OF USE Intellectual Property Copyright Policy

Independent Contractor Agreement Accountant

TERMS OF USE. We may provide, through the Site, Services that include without limitation the:

Transcription:

I-SEE-YOU CONTENT SUBMISSION EXCLUSIVE RELEASE AND GRANT OF RIGHTS *TO BE SIGNED BY PERSON WHO OWNS SUBMISSION (IF OWNER IS A MINOR, PLEASE SEE PAGE 4) Dated: I See You, LLC 5907 Lemona Ave. Van Nuys, CA 91411 Gentlemen: In consideration of the time and resources you expend in evaluating the audio/visual/text content I submitted to you and/or which is owned by me and/or in which I appear (the Submission ) for possible inclusion in the website I-See-You.com and/or the motion picture I-See-You (collectively, I-See-You ) my desire to gain exposure for myself and/or the Submission, my chance to compete for any prize thereon, and for other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, I irrevocably grant to you, your affiliates, licensees, successors and assignees (collectively you or I See You, LLC ) all right, title and interest in and to the Submission and each element contained therein (including, without limitation, all copyrights), and the exclusive right, license and permission to utilize the Submission, or any portion thereof, and to utilize my name, voice, likeness, appearance, performance, and any original material(s) created by me which is (are) incorporated into the Submission (e.g., artwork, dialogue, musical composition(s), literary material, etc.), including, without limitation, all copyrights, in I-See-You, any version thereof and/or any other program, format or production (whether or not related to I-See-You ) in which the Submission or any portion or element thereof might be included as an element (be it television, theatrical motion pictures, home video, the internet, printed media, any form of compilation, and/or in any and all media whether now known or hereafter devised throughout the universe in perpetuity) (collectively a Presentation ), including but not limited to uses in connection with the production, distribution, theatrical or non-theatrical exhibition, advertising, merchandising, telecasting and/or other exploitation of a Presentation, in any and all media, whether now known or hereafter devised, including but not limited to motion picture exhibition, home videos, commercials, any new media, videocassettes, CD s, DVD s, compilations, the internet, printed media, product merchandising, theatrical motion pictures, digital and electronic devices (including gaming devices such as slot machines and entertainment handheld devices and consoles such as Nintendo and cell phones), and all television, be it free, pay, pay-per-view, cable or otherwise, throughout the universe, in perpetuity. The foregoing grant of rights to you includes, without limitation, the right to use my name, voice and/or likeness in and in connection with commercial tie-ins and product endorsements. In the event the grant of the foregoing rights is determined to be ineffective or is

limited in any manner, I irrevocably assign to you, your affiliates, licensees, successors and assignees all right, title and interest in and to the Submission and each element contained therein (including, without limitation, all copyrights), and the exclusive right, license and permission to utilize the Submission, or any portion thereof, and to utilize my name, voice, likeness, appearance, performance (all as set forth above), and any original material(s) created by me which is (are) incorporated into the Submission (e.g., artwork, dialogue, musical composition(s), literary material, etc.), including, without limitation, all copyrights, in a Presentation, including but not limited to uses in connection with the production, distribution, exhibition, advertising, merchandising, telecasting, webcasting and/or other exploitation of a Presentation, in any and all media, whether now known or hereafter devised, including but not limited to home videos, commercials, any new media, videocassettes, CD s, DVD s, compilations, the internet, printed media, product merchandising, theatrical motion pictures, digital and electronic devices (including gaming devices such as slot machines and entertainment handheld devices and consoles such as Nintendo and cell phones), and all television, be it free, pay, pay-per-view, cable or otherwise, throughout the universe, in perpetuity. I also agree that you may use the Submission and any portion thereof, and my name, voice, likeness, appearance, performance, and biographical information to publicize and promote a Presentation and/or broadcaster s (or other applicable broadcast entity s or exhibitor s) services and that you may sell, assign or license your rights hereunder to any third party in your sole discretion and without providing any further consideration to me. You have not promised nor given any assurances that the Submission will be included in a Presentation or otherwise utilized. You have not promised nor given any assurances that I will receive any prize or other compensation if the Submission is included in a Presentation or otherwise utilized. Further, I understand that the Submission may be altered or edited for any reason and in any manner (including without limitation for reasons of content, presentation and time) and may, to the extent decided by you in your sole discretion, have sound effects, music, host voiceovers and/or other elements added to the presentation, and that you may use, adapt and modify the Submission or any portion or element thereof and to combine it with other materials in a Presentation. I hereby release, discharge and hold harmless you, your affiliates, your licensees, successors and assignees, Presentation broadcasters, exhibitors, distributors and any and all other person(s) or entity(es) from any and all claims whether at law or in equity (including without limitation, injunctive relief) that I may have at any time by reason of any such use, exploitation or the exercise of any rights granted hereunder and/or arising from a breach of my representations and warranties hereunder. I acknowledge that, in the event of a breach of this agreement by you or any third party, the damage, if any, caused me thereby will not be irreparable or otherwise sufficient to entitle me to seek or obtain injunctive or other equitable relief. I acknowledge that my rights and remedies in any such event will be strictly limited to the right, if any, to recover damages in an action at law, and I will not have the right to enjoin the production, exhibition, or other exploitation of the Presentation or any allied rights with respect thereto.

I represent and warrant (1) that I am the sole and exclusive owner of the Submission and have the full right and authority to enter into this agreement and to grant the rights herein, (2) that the making, exhibition, distribution and/or other exploitation of the Submission does not violate or infringe the rights of others or constitute a defamation or invasion of privacy or right of publicity, (3) that I have not falsely identified any individual involved in the creation of the Submission or any individual whose appearance or voice is incorporated in the Submission; (4) that I have obtained all necessary consents and permissions required for you to exploit the rights granted to you hereunder and that all executed third party consents and/or releases which I provide to you contain true and accurate contact information for the signing party(ies) and have been actually signed by the legal owner of the rights being granted to you pursuant to such consents and/or releases, and (5) that I am not a member of the Screen Actors Guild, the American Federation of Television and Radio Artists, the Directors Guild of America, the Writers Guild of America, or any like theatrical, motion picture or television union or guild. I hereby agree to indemnify and defend you against any and all losses, claims, debts, demands, liabilities, attorneys fees and all other damages or costs arising from or related to a breach of any of the above representations or warranties or the falsity of any of these representations or warranties, including, without limitation, any and all claims by third parties that their signature(s) has (have) been forged. This Release will be governed by and construed under and in accordance with the laws of the State of California applicable to contracts entered into and fully to be performed therein. I hereby consent and agree to the exclusive jurisdiction of the federal and state courts of the State of California located in the County of Los Angeles, in connection with any lawsuit, action or proceeding arising out of or related to this agreement. I agree to execute any additional documents which you may from time to time require or deem necessary or desirable to evidence, establish, maintain, protect, enforce or defend your exercise and full exploitation of any of the rights I have granted herein including without limitation, your right, title and interest in and to the Submission or any portion or element thereof. If I fail to execute and deliver such documents, I hereby appoint you as my attorney-in-fact, with full right of substitution and delegation, to execute any such documents in my name and on my behalf to effectuate the purpose of this agreement, such power being irrevocable and coupled with an interest. I understand that nothing shall require you to include me or the Submission in a Presentation or to broadcast or otherwise exhibit a Presentation; all such matters are within your sole discretion. I agree that you will have the right from time to time and at any time to cut, edit, add to, subtract from, arrange, rearrange, shorten and revise the Submission in any manner and by any method which you may in your sole discretion determine, and that I expressly waive any so-called moral rights that may now or may hereafter be recognized.

I shall be responsible for and warrant that I will pay all state and federal taxes on any prize that I may win. I release you, your licensees, successors and assigns of liability for any such taxes. You may deduct or require payment of any such tax before delivery of any prize. This agreement constitutes the entire understanding between you and me, and supersedes all prior negotiations, understandings and agreements (whether written or oral) pertaining hereto and cannot be modified except by a writing signed by you and me. Any waiver of any term of this agreement in a particular instance shall not be a waiver of such term for the future. In the event that any paragraph or provision is deleted from this agreement for any reason, such deletion shall have no effect upon the remaining terms and conditions of this agreement hereof. This agreement may be executed in any number of counterparts, each of which when so executed and delivered shall be deemed to be an original and all of which taken together shall constitute one and the same instrument, respectively. I declare under penalty of perjury under the laws of the State of California and of the United States that all statements made by me in this agreement are true and correct, that the name below is my legal name, and that the signature below is my legal signature. I understand and am bound by all terms contained in this agreement. Further, I understand that you would not further evaluate the Submission without this agreement and that should you include the Submission or any portion thereof in a Presentation or exercise any other rights granted hereunder, you will be doing so in reliance on this agreement. Very truly yours, [Print Name] [Current Age] ( ) [Telephone]

TO BE COMPLETED IF OWNER OF SUBMISSION IS UNDER 18 YEARS OF AGE: NAME OF CHILD: CURRENT AGE: I represent and warrant that I am the parent or legal guardian of the minor child (the Minor ) whose name appears above. The Minor and I, both individually, and I as the Minor s parent or legal guardian, agree to be bound by all of the provisions of this agreement. Parent/Guardian: [Print Name] ( ) [Telephone]

* TO BE SIGNED BY PERSON(S) WHO APPEAR AND/OR WHOSE VOICE CAN BE HEARD IN SUBMISSION * Dated: I See You, LLC 5907 Lemona Ave. Van Nuys, CA 91411 Gentlemen: In consideration of the time and resources you expend in evaluating the Submission I submitted to you and/or in which I appear (the Submission ) for possible inclusion in the Presentation I See You, my desire to gain exposure for myself and/or the Submission, and for other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, I irrevocably grant to you, your affiliates, licensees, successors and assignees all right, title and interest in and to the Submission and each element contained therein and the exclusive right, license and permission to utilize the Submission, or any portion thereof, and to utilize my name, voice, likeness, appearance, performance, and any original material(s) created by me which is (are) incorporated into the Submission (e.g., artwork, dialogue, musical composition(s), literary material, etc.), including, without limitation, all copyrights, in I See You, any version thereof and/or any other Presentation, format or production (whether or not related to I See You ) in which the Submission or any portion or frame thereof might be included as an element (be it television, theatrical motion pictures, home video, the internet, printed media, any form of compilation, and/or in any and all media whether now known or hereafter devised throughout the universe in perpetuity) (collectively a Presentation ), including but not limited to uses in connection with the production, distribution, exhibition, advertising, merchandising, telecasting and/or other exploitation of a Presentation, in any and all media, whether now known or hereafter devised, including but not limited to home videos, commercials, any new media, videocassettes, CD s, DVD s, compilations, the internet, printed media, product merchandising, theatrical motion pictures, digital and electronic devices (including gaming devices such as slot machines and entertainment handheld devices and consoles such as Nintendo and cell phones), and all television, be it free, pay, pay-per-view, cable or otherwise, throughout the universe, in perpetuity. The foregoing grant of rights to you includes, without limitation, the right to use my name, voice and/or likeness in and in connection with commercial tie-ins and product endorsements. In the event the grant of the foregoing rights is determined to be ineffective or is limited in any manner, I irrevocably assign to you, your affiliates, licensees, successors and assignees all right, title and interest in and to the Submission and each element contained therein, and the exclusive right, license and permission to utilize the Submission, or any portion thereof, and to utilize my name, voice, likeness, appearance, performance (all as set forth above), and any original material(s) created by me which is (are) incorporated into the Submission (e.g., artwork, dialogue, musical composition(s),

literary material, etc.), including, without limitation, all copyrights, in a Presentation, including but not limited to uses in connection with the production, distribution, exhibition, advertising, merchandising, telecasting and/or other exploitation of a Presentation, in any and all media, whether now known or hereafter devised, including but not limited to home videos, commercials, any new media, videocassettes, CD s, DVD s, compilations, the internet, printed media, product merchandising, theatrical motion pictures, digital and electronic devices (including gaming devices such as slot machines and entertainment handheld devices and consoles such as Nintendo and cell phones), and all television, be it free, pay, pay-per-view, cable or otherwise, throughout the universe, in perpetuity. I also agree that you may use the Submission and any portion thereof, and my name, voice, likeness, appearance, and performance to publicize and promote a Presentation and/or broadcaster s (or other applicable broadcast entity s or exhibitor s) services and that you may sell, assign or license your rights hereunder to any third party in your sole discretion and without providing any further consideration to me. I understand, acknowledge and agree that I will not receive any prize or other compensation if the Submission is included in a Presentation or otherwise utilized or not used at all. Further, I understand that the Submission may be edited for any reason and in any manner (including without limitation for reasons of time) and may, to the extent decided by you in your sole discretion, have sound effects, music, host voiceovers and/or other elements added to the presentation, and that you may use, adapt and modify the Submission or any portion or element thereof and to combine it with other materials in a Presentation. I hereby release, discharge and hold harmless you, your affiliates, your licensees, successors and assignees, Presentation broadcasters, and any and all other person(s) or entity(ies) from any and all claims whether at law or in equity (including without limitation, injunctive relief) that I may have at any time by reason of any such use, exploitation or the exercise of any rights granted hereunder. I acknowledge that, in the event of a breach of this agreement by you or any third party, the damage, if any, caused me thereby will not be irreparable or otherwise sufficient to entitle me to seek or obtain injunctive or other equitable relief. I acknowledge that my rights and remedies in any such event will be strictly limited to the right, if any, to recover damages in an action at law, and I will not have the right to enjoin the production, exhibition, or other exploitation of the Presentation or any allied rights with respect thereto. I represent that I, the undersigned, am in fact the individual appearing in the Submission and that I am not a member of Screen Actors Guild, the American Federation of Television and Radio Artists, the Directors Guild of America, the Writers Guild of America, or any like theatrical, motion picture or television union or guild. This release will be governed by and construed under and in accordance with the laws of the State of California applicable to contracts entered into and fully to be performed therein. I hereby consent and agree to the exclusive jurisdiction of the federal and state courts of the State of California, located in the County of Los Angeles, in connection with any lawsuit,

action or proceeding arising out of or related to this agreement. I agree to execute any additional documents which you may from time to time require or deem necessary or desirable to evidence, establish, maintain, protect, enforce or defend your exercise and/or full exploitation of any of the rights I have granted herein including, without limitation, your right, title and interest in and to the Submission or any portion or element thereof. If I fail to execute and deliver such documents, I hereby appoint you as my attorney-in-fact, with full right of substitution and delegation, to execute any such documents in my name and on my behalf to effectuate the purpose of this agreement, such power being irrevocable and coupled with an interest. I understand that nothing shall require you to include me or the Submission in a Presentation or to broadcast or otherwise exhibit a Presentation; all such matters are within your sole discretion. This agreement constitutes the entire understanding between you and me, and supersedes all prior negotiations, understandings and agreements (whether written or oral) pertaining hereto and cannot be modified except by a writing signed by you and me. Any waiver of any term of this agreement in a particular instance shall not be a waiver of such term for the future. In the event that any paragraph or provision is deleted from this agreement for any reason, such deletion shall have no effect upon the remaining terms and conditions of this agreement hereof. This agreement may be executed in any number of counterparts, each of which when so executed and delivered shall be deemed to be an original and all of which taken together shall constitute one and the same instrument, respectively. I declare under penalty of perjury under the laws of the State of California and of the United States that all statements made by me in this agreement are true and correct, that the name below is my legal name, and that the signature below is my legal signature I understand and am bound by all terms contained in this agreement. Further, I understand that you would not further evaluate the Submission without this agreement and that should you include the Submission or any portion thereof in a Presentation or exercise any other rights granted hereunder, you will be doing so in reliance on this agreement. Very truly yours, [Print Name] [Current Age] ( ) [Telephone]

TO BE COMPLETED IF PERSON APPEARING AND/OR WHOSE VOICE IS HEARD IN THE SUBMISSION IS UNDER 18 YEARS OF AGE: NAME OF CHILD: CURRENT AGE: I represent and warrant that I am the parent or legal guardian of the minor child (the Minor ) whose name appears above. The Minor and I, both individually, and I as the Minor s parent or legal guardian, agree to be bound by all of the provisions of this agreement. Parent/Guardian: [Print Name] ( ) [Telephone]

TO BE SIGNED BY ANY ADDITIONAL ADULT PERSON(S) APPEARING AND/OR WHOSE VOICE IS HEARD IN THE SUBMISSION terms. I (we) have read the foregoing agreement and agree to be bound by all of its Very truly yours, [print name / current age] [signature] [date] [address] [telephone] [e-mail address] [print name / current age] [signature] [date] [address] [telephone] [e-mail address] [print name / current age] [signature] [date] [address] [telephone] [e-mail address] [print name / current age] [signature] [date] [address] [telephone] [e-mail address] [print name / current age] [signature] [date] [address] [telephone] [e-mail address]

TO BE SIGNED BY THE PARENT OF ANY ADDITIONAL MINOR(S) APPEARING AND/OR WHOSE VOICE IS HEARD IN THE SUBMISSION Each parent/legal guardian signing below represents and warrants that he/she is the parent or legal guardian of the minor child (the Minor ) whose name appears directly above such parent s/legal guardian s signature and each Minor and the parent/legal guardian of each Minor (both individually and as such minor s parent/legal guardian) agrees to be bound by all of the provisions of this agreement. NAME OF CHILD: [Print Name] ( ) [Telephone] NAME OF CHILD: [Print Name] ( ) [Telephone] NAME OF CHILD: [Print Name] ( ) [Telephone] CURRENT AGE: Parent/Guardian: CURRENT AGE: Parent/Guardian: CURRENT AGE: Parent/Guardian: