In consideration of compensation as indicated below, receipt of which is hereby acknowledged,

 

I,__________________________	___________________	_____________________________
(First Name)	(Middle Name)	(Last Name)

 

do hereby irrevocably authorize Rhythm Productions Inc."Adultwebcamworld" (hereinafter "Primary Producer") and Broadcasting concepts Inc."Peekshows.com" (hereinafter "Secondary Producer") its representatives, assigns and those acting under its permission and on its authority, to copyright, publish, and use in all forms of media and in manners for advertising, trade, promotion, exhibition, or any other lawful purpose whatsoever, still, single, multiple or moving photographic or digital images, pictures or video of me in which I may be included in whole or in part, alone or in conjunction with other persons, or composite or distorted in character or form, in conjunction with my fictitious name

 

____________________	_____________________	____________________, (Stage Name)
Option1:	Option 2:	Option 3

 

or reproductions thereof in color otherwise or in derivative works made through any medium.

I do hereby waive any right that I may have to inspect or approve the finished product or advertising or other copy that may be used in connection therewith or the use to which they may be applied.

 

I hereby release and agree to hold harmless Primary Producer and Secondary Producer, his legal representatives, assigns, and those acting under its permission :trom any liability by virtue of blurring, distortion, alteration, optical illusion, or use in composite form whether intentional or otherwise, that may occur or be produced in the taking of the pictures, or in any processing tending toward the completion ofthe finished product.

 

I hereby affirm by my signature below that all poses, positions and situations enacted in the still, single, multiple or moving photographic or digital images or pictures covered in this re­lease were entered into without force, coercion, or threat whatsoever, and were posed freely by me with my full consent in return for monetary compensation and for my own amusement. I further agree to hold blameless and free of all accusation of such force or coercion Primary Producer and Secondary Producer, his legal representatives, assigns, and those acting under its permission and authority.

 

I do hereby warrant that I am of full legal age and have every right to contract in my own name in the above regard. Further, I have read the above authorization and release, prior to its exe­cution, and I am fully familiar with the contents thereof.

 By:

Print Model Real Name: ________________________			Model Signature: _________________________
Date of Birth:			Todays Date:
Month:_________________	Day:______	Year:19____	Month:__________	Day:______	Year:2008
Expiry Date of I.D.			Please indicate address you will be working from
Month:_________________	Day:______	Year:20____	Same as home:
Home Address:_______________________________			Work Address Location:________________________
___________________________________________			___________________________________________
City:___________________	State/Prov____________		City___________________State/Prov____________
Zip/Postal:________________			Zip/Postal________________
Country:_____________________________________			Country ______________________________________