Model/Talent Release

Photography and Videography

For good and valuable consideration, the receipt and sufficiency of which is hereby
acknowledged, I, _________________________________________, the undersigned
(“Talent”), agree as follows:

1. I agree to be photographed, recorded and videotaped by Quality Time Resources, LLC and/or
its agents (“Company”) in connection with my participation in ___________________________
on _____________________.

2. I hereby irrevocably authorize Company and its affiliates to copyright, publish, reproduce,
exhibit, transmit, broadcast, televise, digitize, display, otherwise use, and permit others to use,
(a) my name, image, likeness, and voice, and (b) all photographs, recordings, videotapes,
audiovisual materials, writings, statements, and quotations of or by myself (collectively, the
“Materials”), in any manner, form, or format whatsoever now or hereinafter created, including
on the Internet, and for any legal purpose whatsoever, including, but not limited to, advertising
or promotion of Company, its affiliates, or their services, without further consent from or
payment to me.

3. I hereby waive any right that I may have to inspect and/or approve the finished product or
products or the editorial, advertising, or printed copy or soundtrack that may be used in
connection therewith and any right that I may have to control the use to which said product,
products, copy and/or soundtrack may be applied.

4. I hereby release, discharge and agree to save [Production Company Name], their licensees,
successors, legal representatives and assigns from any liability by virtue of any blurring,
distortion, alteration, optical illusion or use in composite form whether intentional or otherwise
that may occur or be produced in the making, processing, duplication, projecting or displaying of
said picture or images, and from liability for violation of any personal or proprietary right that I
may have in conjunction with said pictures or images and with the use thereof.

5. It is understood that all of the Materials, and all films, audiotapes, videotapes, reproductions,
media, plates, negatives, photocopies, and electronic and digital copies of the Materials, are the
sole property of Company. I agree not to contest the rights or authority granted to Company
hereunder. I hereby forever release and discharge Company, its employees, licensees, agents,
successors, and assigns from any claims, actions, damages, liabilities, costs, or demands
whatsoever arising by reason of defamation, invasion of privacy, right of publicity, copyright
infringement, or any other personal or property rights from or related to any use of the Materials.
I understand that Company is under no obligation to use the Materials.

4. This document contains the entire agreement between the Company and the undersigned
concerning the subject matter hereof.

Agreed and Accepted this __________ day of _________________________, 2015.

___________
Initials
Talent Quality Time Resources, LLC
An Arizona Limited Liability Company

____________________________ ____________________________
Signature of Talent David Niecikowski, President

Talent Information:

____________________________ ____________________________
Date of Birth Social Security Number

_____________________________________________________________________
Address/City/State/Zip

____________________________
Phone Number

_____________________________________________________
If Talent is a Minor (an individual under 18 years of age) or subject to a guardianship agreement complete the
following.

I, ____________________________________________________, the parent/legal guardian of the above-named

minor endorse, agree, and accept the above terms and conditions on behalf of the herein-named minor.

____________________________ ____________________________
Signature of Parent/Guardian Printed Name of Parent/Guardian

____________________________ ____________________________
Date of Birth Phone Number

_____________________________________________________________________
Address/City/State/Zip

___________
Initials