In consideration of the sum of _____________________________Dollars ($________) and other valuable consideration, receipt of which is hereby acknowledged, I, __________________________________________, residing at ___________________________________________________________________________________, do, irrevocably authorize _____________________________________________________________________(the Photographer), his or her assigns, licensees, successors in interest, legal representatives, and heirs to copyright, publish, and use in all forms and media and in all manners for advertising, trade, promotion, exhibition, or any other lawful purpose, images of the following property:____________________________________________________________

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which I own and have full and sole authority to license for such uses, regardless of whether said use is composite or distorted in character or form, whether said use is made in conjunction with my own name or with a fictitious name, or whether said use is made in color, black and white, or otherwise, or other derivative works are made through any medium.

I waive any right that I may have to inspect or approve the photograph(s) or finished version(s) incorporating the photographs, including written copy that may be used in connection therewith.

I am of full age and have every right to contract in my own name with respect to the foregoing matters. I agree that this release shall be binding on me, my legal representatives, heirs, and assigns. I have read the above authorization and release prior to its execution and I am fully cognizant of its contents.

Witness_____________________________ Signed___________________________________

Address_____________________________ Address__________________________________

Date ____________, 20_____