In consideration of the opportunity to provide certain statements and participate in photography or audio/video taping relating to certain products of Island Reflections Dance Theatre Company (IRDTC) I, (Person name on the First Name section of this form), for myself or in the case of a minor, (“Minor”), in my capacity as the Minor's parent/guardian, agree as follows:

1. I hereby consent to the recording of statements, photographs, and/or audio/video recordings taken of the Minor or me by IRDTC or its contractors.

2. All statements, photographs, and/or audio/video recordings taken of the Minor or me, by IRDTC or its contractors, may be used by IRDTC for promotional, commercial or other purposes as determined by IRDTC Artistic Director anywhere in the world in its sole discretion. Neither the Minor nor I shall have any right to control the use or publication by IRDTC of the statements, photographs, and/or audio/video recordings.

3. All statements, photographs, and/or audio/video recordings taken of the Minor or me by IRDTC or its contractors, shall be the sole property of IRDTC. Neither the Minor nor I shall receive any compensation in connection with use of these statements, photographs, and/or audio/video recordings for promotional, commercial or other purposes.

4. On behalf of the Minor and myself, I hereby release, waive and discharge any claims of any kind or nature arising out of or relating to the use of the statements, photographs, and/or audio/video recordings against IRDTC or any person or firm authorized by IRDTC to publish said materials (“Publisher”). Such release, waiver and discharge shall also extend to all affiliated companies, shareholders, directors, officers, employees, agents and assigns of IRDTC and any Publisher.

5. This Release shall be binding upon the Minor and me, and our respective successors, heirs, assigns, executors, administrators, spouse and next of kin.

6. I HAVE READ THIS DOCUMENT AND I UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS ON BEHALF OF THE MINOR AND MYSELF(INCLUDING RIGHTS RELATING TO PUBLICITY AND PRIVACY WITH RESPECT TO THE COMMERCIAL USE OF ANY STATEMENTS, PHOTOGRAPHS, AND/OR AUDIO/VIDEO RECORDINGS) AND I SIGN THIS RELEASE FREELY AND VOLUNTARILY.