Customer Name_______________________________________________________

PHOTOGRAPHER'S COPYRIGHT CONSENT FORM

I own the copyright in the accompanying film, print, slide, movie, artwork, CD ROM, disk or other material (all referred to in this document as the "photos") depicting:

(Describe the content of the photos)

I authorized ______________________________ (Your company Name) to reproduce the photos and to deliver them to ______________________________ (Customer). Any restrictions on the customer's use of the photos are written on the front or reverse side of this forms.

Check the appropriate blanks.

This release is for:

Blanket use for this customer	One time use
The photos described above	All photos by me

Notify me when the photos are copies: Yes No

Address/Telephone: ______________________________________________________

______________________________________________________________________

Customer represents that the above form has been properly signed by the copyright owner. Customer also agrees to pay the charges for processing and/or printing the photos, and to indemnify and hold harmless _____________________________________ (Your company name) and its agents for all liability, damages and expenses (including reasonable actual attorney fees) it may incur as a result of its processing and/or printing the photos, including any claims brought by any other person claiming an interest in the photos or in their subject matter.

Address : ______________________________________________________

Accepted by: ____________________________________________________