MEDIA RELEASE AND WAIVER

between
AMT S.A. Advanced Maritime Transports (“AMT”)
AND

( )

This waiver is in respect of a promotional film which AMT intends on creating (hereafter
referred to as the “Purpose”). In respect of the Purpose, I hereby grant AMT, its directors,
officers and employees’ non-revocable permission to utilise any photographs, videotapes,
digital media, company name, audio records, or any other audio, visual, online or interactive
media (hereafter referred to as “media”) which solely relates to any and only projects
entered into with any of the AMT affiliates.

I acknowledge that AMT will use such Media and further grant AMT permission to copyright,
display, publish, distribute, use, modify, print and reprint such images in any manner related
to the Purpose. The Media utilised shall be used solely for the purpose of the promotional
film. I waive any right to inspect or approve the use of the media by AMT prior to its use and
provide a blanket consent for the use of any digital material and Media in connection with
any projects. I hereby consent to and forever release and hold AMT harmless from any and
all liability arising out of the use of the images in any manner or Media whatsoever, and
waive any and all claims and causes of action relating to use of the Media, including without
limitation, claims for invasion of privacy rights or publicity.

Company: _______________________

Representative’s Name: _______________________

Signature: _______________________

Date: _______________________

AMT S.A. Advanced Maritime Transports - Route Suisse 8 A - 1163 Etoy - Switzerland
www.amt-sa.com
Société Anonyme au capital de CHF 200‘000 - Numéro IDE : CHE-104.893.579