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Photo Release Form

I, , herby grant and authorize Tri County Ninja LLC ("TCN") the right to take, edit, alter, copy, exhibit, publish, distribute and make use of any and all pictures or video taken of me, my spouse or my children to be used in and/or for legally promotional materials including, but not limited to, newsletters, flyers, posters, brochures, advertisements, fundraising letters, other print and digital communications, without payment or any consideration. This authorization extends to all languages, media, formats and markets now known or hereafter devised. This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing.

I understand and agree that these materials shall become the property of TCN and will not be returned.

I hereby hold harmless, and release TCN, any of its officers, directors, shareholders, employees, agents, representatives, successors and assigns from all liability, petitions, and causes of action which I, my heirs, representative, executors, administrators, or any other persons may make while acting on my behalf or on behalf of my estate.

If participating client is under the age of 18, a parent or guardian must sign this release.

PARTICIPATING CLIENT: UNDER 18:

PRINTED NAME: SIGNED DATE:

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Your legal name

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

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October 16, 2018 1:43 pm EDT

Photo Release Form Uploaded by Ed McNulty - staff@tricountyninja.com IP 97.84.201.94