1402077.3

APPEARANCE RELEASEProduction:Date:Shooting Date(s):Shooting Location(s):Person Appearing (please print):ID #:Address:Phone:Email:

For good and valuable consideration, the receipt and sufficiency of which are hereby acknowl-edged, I am executing this authorization and release (this “

Release

") for the benefit of ...andcompany, LLCand itsparents, affiliates, subsidiaries, licensees, successors and assigns,andeach of their respective officers,employees, agents and representatives (collectively, “

Pro-ducer

” or "

you

").I agree that you shall have the sole discretion to film, videotape and photograph me, and re-cord my appearance, poses, movements, voice, statements, conversation, soundsand musicalcompositions, and edit the foregoing,and use my nameand use any biographical materialconcerning me (collectively "

my performance

"), during and in connection with my appearancein the Production. I waive any right of inspection or approval of my performance or the uses towhich my performance may be put. I expressly release you, and your agents, employees andrepresentatives, from any and all claims which I have or may have, including without limitationinvasion of privacy, right of publicity, defamation or any other cause of action,arising out of theproduction, duplication, broadcast, exhibition or other exploitation of my performance. I further represent that any statements made by me during my performance are true, to the best of myknowledge, andthat neither they nor my performance will violate or infringe upon the rights of any third party. If I provide you with or display any photographs, published works and/or other artistic materials, then I will have obtained all of the rights, clearances and releases necessaryfor youto exploit said materials in the Production. I acknowledge that you will rely on this Re-lease, potentially at substantial cost to you.Iagree to defend, indemnify and hold Producer harmless against any breach or alleged breachby me in connection with this Release.All film, videotape, still photographs and other visual and/or audio recordings or representa-tions of my performance are collectively referred to herein as the "

Materials

". Producershallbe the sole and exclusive owner of the Materials as a work made for hire, with the right for thefull period of copyright, including all extensions and renewals thereof, and thereafter in perpe-tuity, throughout the universe, to use and re-use, an unlimited number of times, all or any partof the Materials for all purposes, including without limitation for purposesof making and pro-ducing audio-visual productions and other works, and advertising, publicizing and exploitingthe same, by all means and in all media, whether now known orhereafter devised, in any andall languages, and to authorize others so to do.To the extent that such results and proceedsare found not to be a work made for hire, I hereby grant and assign to Producer all right, titleand interest to the Materials throughout the universe, in perpetuity, in all media, whether nowknown or hereafter devised. Neither I, nor any other party claiming through me, shall have anyright of action against Produceror any other party arising out of any use of said Materials, in-