CUSTOMER PHOTO RELEASE WAIVER

For valuable consideration, __________________________________, hereby authorizes

Images of Time Photography and its representatives, to take photographs for the purposes
outlined below and to use or publish such photos (either still photos or film/video as Images of
Time Photography sees fit and !ustomer waives any rights and any claims that it might make
regarding the taking or publishing of any such photos" In addition, !ustomer hereby authorizes
Images of Time Photography to use such photos and related materials as follows#
$" %se and permit to be used !ustomer&s name, informative material concerning !ustomer,
and its likeness (either in whole or in part, whether in original or modified form and whether
alone or in con'unction with any other material and te(t matter as Images of Time Photography
may determine for the purposes of advertising, publicizing, and promoting in every manner in all
media past, present, and/or future Images of Time Photography related events and/or activities,
without further consideration, e(cept where prohibited by law"
)" Identify !ustomer&s likeness or reproduction thereof in con'unction with any use
mentioned above, either by !ustomer&s own name or by a pseudonym or other description"
!ustomer agrees to waive its right to privacy/publicity" !ustomer agrees that it shall have no
right to inspect or approve any likeness or statement or any e(ercise of any of the authorizations
granted by it hereunder" !ustomer agrees that any still or motion picture taken of it by Images of
Time Photography is owned by Images of Time Photography"
*" !ustomer hereby e(pressly releases, relin+uishes, and forever discharges Images of Time
Photography of and from any and all claims, which it may have against Images of Time
Photography arising out of use of the aforementioned photographs and all related activities"
," The term of this authorization shall commence on this date and shall continue for a period
of five years thereafter"
PRINT Name and Address:
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.egal /ame of !ustomer 0ate
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1ddress !ity/ 2tate/ 3ip
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0ate of 4irth (%nder 1ge $5 1uthorized 2ignature
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/ame of 2ignatory Title of 2ignatory
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(If under $5 years of age Parent/6uardian signature is re+uired"
$ of $