I hereby grant Live Free Adventures, LLC (LFA) permission to publish in print, electronic, video or any other media format the likeness or image of myself. I release all claims against LFA with respect to copyright ownership and publication, including any claim for compensation related to use of the materials. I understand that my participation in any media produced by LFA confers upon me no right to ownership whatsoever. I acknowledge LFA’s right to crop or treat photographs(s), slide(s) or videos at its discretion and I authorize use of the image(s) without consideration. I also acknowledge that LFA may choose not to use my photograph(s) or image(s) at this time, but may do so at a later date.

I also agree to release and hold harmless LFA, its agents and employees, from any claims, damages or liability arising from or relating to the use of my image(s) including, but not limited to any sale or re-use, distortion, alteration, optical illusion, or use in composite form, either intentionally or otherwise, that may occur in the production of the finished product.

I understand that LFA reserves the right to copy, exhibit, sell, publish and/or distribute this/these photo(s) for any lawful purpose. I also understand that LFA may discontinue use of photos, slides or videos without notice.

I certify that I am at least 18 years of age and competent to contract my own name. I have read and understand this release completely before signing below and fully understand the contents, meaning and impact of all terms.

Signature: _______________________________________ Date: _______________

Name: (print clearly):___________________________________________________

Address: _____________________________________________________________

Phone Number: ______________________ Email: ___________________________

Name of group or institution (if applicable): _________________________________

If the person singing is under age 18 there must be consent by a parent or legal guardian as follows:

I hereby certify that I am the parent or legal guardian of: __________________________, named above and do hereby give my consent without reservation to the foregoing behalf of this person.

Parent / Guardian’s Signature: ___________________________ Date: ______________

Parent / Guardian’s printed name: ____________________________________________

______ I agree that my name may be used as a caption with the images

______ I request that my name not be associated with any image created