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In consideration of my participation in the audiovisual production presently entitled “Trek Initiative” / “Warp 5.0” (hereinafter “Picture”) and other good and valuable consideration, receipt of which I hereby acknowledge (it being understood that I shall not receive any monetary consideration), I hereby irrevocably grant and give you, initially in connection with the Picture, but otherwise without limitation, the right to any time and from time-to-time to photograph, televise, record, portray, depict and refer to my acts, poses, plays, appearances and utterances of any and all kinds to produce and reproduce the same in whole or in part, by photography (still and motion picture), printing, drawing, visual and/or aural recording, television and any and all other methods now or hereafter known (all of which are hereinafter referred to as “reproductions”), and to distribute, exploit, market, disseminate, display and otherwise use the same as you may desire, in any medium or by any means now or hereafter known; under any descriptive words or names, including my own name; for any advertising, publicity, copyright, merchandising, publishing, informative, trade, commercial or other purposes; in connection with any products, services, business activities and business concerns; and in any form, modification, re-arrangement, combination or alteration.

I agree and acknowledge that any and all reproductions made or to be made by you shall be your sole and exclusive property, and I shall have no claim thereto or rights therein, or in the proceeds thereof. I hereby irrevocably signify my consent, authorization and permission to and for any and all sales, leases, assignments, licenses or other dispositions of, dealings with, or uses of the reproductions upon such terms and in such manner and at such times as you may elect.

I hereby forever release and discharge you and your officers, directors, employees and agents, of and from any and all liability, claims, demands, suits, bills in equity and causes of action which I ever had, now have, or at any time in the future may have based upon, attributable to or relating to your exercise of any rights granted hereunder or your reliance upon any agreements herein made by me. I certify that I am over eighteen (18) years of age. (If under eighteen years of age, consent form must be signed by parent or legal guardian).

In no event may I terminate or rescind this agreement or seek to enjoin or restrain the development, production, distribution or exploitation of the Picture or any part thereof or any materials relating thereto or derived therefrom, or the use, publication, or dissemination of any advertising, promotion merchandising, or publicity in connection therewith, or to seek to obtain any other equitable relief with respect to any breach hereunder or otherwise.

All references herein to “you”, “your” and words of similar import are intended and shall be deemed to include you and your successors, assigns, designees, licensees, agents and lessees. All reference herein to “I”, “me” and words of similar import are intended and shall be deemed to include me, my executors, administrators, heirs, next-of-kin, legal representatives and assigns.

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