JLTV Video Release Form

Video Title (Please print Video Title, First Name and Last Name directly on DVD or VHS TAPE): _____________________________________________________________ In consideration of the time and resources you expend in evaluating the videotape I am submitting to you and/or which is owned by me and/or in which I appear (the "Videotape") for possible inclusion in one or more programs on your television network 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 Videotape and each element contained therein (including, without limitation, all copyrights), and the license and permission to use the Videotape, or any portion thereof, and to use my name, voice and likeness, in programs on your television networks or any other production in which the Videotape or any portion or frame thereof might be included as an element (be it television, home video, the internet, print media, any form of compilation, and/or in any and all media whether now known or hereafter devised) (collectively a "Program"), throughout the universe, in perpetuity. I also agree that you may use the Videotape and any portion thereof, and my name, voice, likeness and biographical information, to publicize and promote a Program and/or your 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 that I will not receive any monetary or other compensation if the Videotape is included in a Program or otherwise used as authorized herein. Further, I understand that the Videotape may be 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 Videotape or any portion or element thereof and combine it with other materials in a Program. I hereby release, discharge and hold harmless you, your affiliates, your licensees, successors and assignees, and any and all other person(s) or entity(es) from any and all claims 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 represent and warrant (i) that prior to granting the rights in this document, I was the sole and exclusive owner of the videotape and had the full right and authority to enter into this agreement and to grant the rights herein, (ii) that the Videotape was shot with a non-professional home video camcorder, (iii) 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' fee 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.

This Release will be governed by and construed in accordance with the laws of the State of California applicable to contracts entered into and fully to be performed therein. I understand and am bound by all terms contained in this Agreement. Further, I understand that (i) nothing shall require you to include me or the Videotape in a Program or to broadcast or otherwise exhibit a Program, (ii) you

cannot be responsible for lost or misdirected tapes, (iii) the Videotape will become your property and will not be returned to me, and (iv) you would not evaluate the Videotape without this Agreement and that, should you include the Videotape or any portion thereof in a Program or exercise any other rights granted hereunder, you will be doing so in reliance on this Agreement.

Signature: ______________________________________ Print Name: ______________________________________ Social Security #: _________________________________ Address: _______________________________________________ _______________________________________________ _______________________________________________ Phone Number: (Home) _________________________________________ (Work) __________________________________________
TO BE COMPLETED IF PERSON APPEARING AND/OR WHOSE VOICE IS HEARD IN THE VIDEOTAPE IS UNDER 18 YEARS OF AGE: NAME OF CHILD: ______________ 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:

Signature: ______________________________________ Print Name: ______________________________________ Address: _______________________________________________ _______________________________________________ _______________________________________________ Phone Number: (Home) _________________________________________ (Work) __________________________________________