I, __________________, Contact Info: ______________, the parent/guardian of ___________, Aged _______ Years, (herein in referred to as “Minor”) hereby grant and authorize ______________ Contact Info: _____________the right to take, edit, alter, copy, publish or make use of the Minor’s photos in a lawful purpose. I acknowledge that I have consented and willingly provided ____________ with the Minor’s photographs to use and reuse as illustrations in the book titled _______________.

The authorization shall extend indefinitely, unless I request for ______________ to cease from further use of the Minor’s likeness and/or photos before the book is published.

I understand that photographs transferred to ____________ shall become their property and shall not be returned. ____________ shall be the sole owner of the photographs and shall have and enjoy all and any proprietary right over the photographs indefinitely.

I acknowledge that I have agreed for the Minor’s likeness to be used without any compensation. I waive any and all right to royalties arising and/or related to the use of the Minor’s likeness.

I hereby hold harmless and release ______________ from any and all liability, real or imagined, legal or otherwise, petitions and causes of action in which, the Minor, Minor’s representatives, executors, administrators, and/or any other person may make while acting on the Minor’s behalf.

I agree that in the event of disputes, ________ and I shall use arbitration to solve the matters. This release form is governed by and construed in accordance with the laws of the State of _______, USA. Exclusive jurisdiction and venue shall be in __________, USA.

I represent that I am at least eighteen (18) years of age and I am fully competent to sign this Release.

I have carefully read and I understand the provisions in this Parental Consent and Release Form and I freely, knowingly and voluntarily sign;

DATE: __________________

NAME: ___________________________    SIGNATURE: _________________________

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