SERIES / PROGRAM TITLE: PRODUCTION DATE: Permission is hereby grante to !"OUR COMPAN" NAME# to $se the %ro%erty &o'ate at

'onsisting o( (or the %$r%ose o( %hotogra%hing an re'or ing s'enes (or the abo)e %rogram %ro $'e by !"OUR COMPAN" NAME#* Permission in'&$ es the right to bring %ersonne& an e+$i%ment onto the %ro%erty an to remo)e them a(ter 'om%&etion o( the ,or-* The %ermission herein grante sha&& in'&$ e the right. b$t not the ob&igation. to %hotogra%h the a't$a& name 'onne'te ,ith the %remises an to $se s$'h name in the %rogram/s0* The $n ersigne hereby gi)es to !"OUR COMPAN" NAME#. its assigns. agents. &i'ensees. a((i&iates. '&ients. %rin'i%a&s. an re%resentati)es the abso&$te right an %ermission to 'o%yright. $se. e1hibit. is%&ay. %rint. re%ro $'e. te&e)ise. broa 'ast an istrib$te. (or any &a,($& %$r%ose. in ,ho&e or in %art. thro$gh any means ,itho$t &imitation. any s'enes 'ontaining the abo)e es'ribe %remises. a&& ,itho$t ins%e'tion or ($rther 'onsent or a%%ro)a& by the $n ersigne o( the (inishe %ro $'t or o( the $se to ,hi'h it may be a%%&ie * !"OUR COMPAN" NAME# hereby agrees to ho& the $n ersigne harm&ess o( an (ree (rom any an a&& &iabi&ity an &oss ,hi'h !"OUR COMPAN" NAME#. an /or its agents. may s$((er (or any reason. e1'e%t that ire't&y 'a$se by the neg&igent a'ts or e&iberate mis'on $'t o( the o,ner o( the %remises or its agents* The $n ersigne hereby ,arrants an re%resents that the $n ersigne has ($&& right an a$thority to so&e&y enter into this agreement 'on'erning the abo)e es'ribe %remises. an that the $n ersigne hereby in emni(ies an ho& s !"OUR COMPAN" NAME#. an /or its agents. harm&ess (rom an against any an a&& &oss. &iabi&ity. 'osts. amages or '&aims o( any nat$re arising (rom. gro,ing o$t o(. or 'on'erning the $se o( the abo)e es'ribe %remises e1'e%t those ire't&y 'a$se by the neg&igent a'ts or e&iberate mis'on $'t o( !"OUR COMPAN" NAME#. or its agents* 2y: Signat$re o( A$thori3e Pro%erty Re%resentati)e Date:

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