Agenda - 04-21-2009 - 4k - Laserfiche WebLink

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Standard Appearance Release For good and valuable consideration, receipt of which is hereby acknowledged, I authorize Advanced Medical Productions, Inc. dba Figure 8 Films ("Producer") and DISCOVERY COMMUNICATIONS, INC. ("DCI") and their respective parents, affiliates, subsidiaries, licensees, successors and assigns to make use of my appearance for the following program, under the working title: Pick of the Litter ("Program") and in connection with Producer and/or DCI or otherwise. I agree that you may tape and photograph me, and record my voice, conversations and sounds, including any performance of any musical composition(s), and including photographing, taping, or recording regarding my friends' or family's medical condition(s) or treatment(s), during and in connection with my appearance and that you shall be the exclusive owner of the results and proceeds of such taping, photography and recording with the right, throughout the world, an unlimited number of times in perpetuity, to copyright, to use and to license others to use, in any manner, including on the Internet, all or any portion thereof or of a reproduction thereof in connection with the Program or otherwise. I further agree that you may use and license others to use my name, voice, likeness and any biographical material concerning me which I may provide, in any and all media, including the Internet, whether now known or hereafter discovered, and in the promotion, advertising, sale, publicizing and exploitation of the Program and ancillary products in connection with the Program, and in connection with Producer and/or DCI or DCI's affiliated services, throughout the world in any and all media, including the Internet, whether now known or hereafter discovered, an unlimited number of times in perpetuity. I further represent that any statements made by me during my appearance are true, to the best of my knowledge, and that neither they nor my appearance will violate or infringe upon the rights of any third party. I hereby waive any right of inspection or approval of my appearance or the uses to which such appearance may be put. I acknowledge that you will rely on this permission potentially, at substantial cost to you and hereby agree not to assert any claim of any nature whatsoever against anyone relating to the exercise of the permissions granted hereunder. I hereby acknowledge that I am solely responsible for any statements made by me during my appearance in the Program, which statements shall consist solely of my opinions and do not necessarily represent those of Producer or DCI, who are not responsible for the content of such statements. I hereby acknowledge that neither Producer nor DCI makes any representations or warranties of any kind with respect to any medical or other advice or information that I may receive in connection with my appearance in the Program, and that I have not relied on any such representations or warranties in agreeing to participate in the Program or execute this Appearance Release. (Please Print) Name: Signature Address: Date City/State/Zip: Phone: I am a parent (or guardian) of the minor who has signed this release and consent and I hereby agree that I and the said minor will be bound by all the provisions contained herein. Name: 307 W. Weaver Street Carrboro, NC 27510 Voice (919) 933-3553 Fax (919) 933-3613 www. figure8films.ty