Retreat Media Waiver

PHOTOGRAPH/VIDEO/TESTIMONIAL RELEASE FORM

I hereby grant to the And Go Media, LLC, a Puerto Rico limited liability company, its related affiliate companies and other third party licensees, representatives or agents (collectively, “And Go Media”), the worldwide, absolute and irrevocable right and unrestricted permission to take photographs or videos that may contain my likeness, as well as the likeness or image of my property, which may include my website/screenshot, now or in the future (the “Photographs”), to take, record, publish or obtain testimonials or other statements from me (the “Statements”), and to use, copy, modify, adapt, translate, distribute, publish, display, exhibit and otherwise use, either in whole or in part, the Photographs and/or Statements for commercial and business purposes. in (i) one or more film, videotape, or multimedia productions; (ii) on GoDaddy’s website, and/or (iii) in any educational, advertising, marketing and promotional materials.

I represent that all Statements are truthful and accurate, and, to the best of my knowledge, neither the Statements nor Photographs will violate or infringe upon the right of any third party.

I acknowledge that all Photographs/Video and/or Statements taken from the shoot dated January 27, 2020 will be used by GoDaddy for advertising purposes, and that GoDaddy shall be the sole and exclusive owner of all right, title, and interest in all copyrights, trademark rights, and any and all other intellectual property rights, worldwide, in the Photographs and/or Statements and the individual components thereof. I shall take no action to challenge or object to the validity of such rights or GoDaddy’s ownership or registration thereof.

I hereby release and discharge, GoDaddy, its employees, agents, successors, licensees, representatives and assigns from any and all claims I might have in connection with GoDaddy’s use, display, dissemination or exploitation of the Photographs and/or Statements, including, but not limited to, any claims for defamation; violation of any moral or artist rights; and/or any right of privacy or publicity. My participation in any Statements or Photographs is entirely voluntary. I understand that GoDaddy is not obliged to make use of the Photographs and/or Statements or otherwise exercise any of the rights granted to GoDaddy by this release. I acknowledge that I may receive no compensation from GoDaddy other than any goodwill and publicity consideration that I receive relating to the publication, distribution or other use of the Photographs and/or Statements as set forth in this release.

This release is being made and entered into under the laws of the State of Arizona, USA and shall be governed and interpreted in accordance with the laws thereof. This release embodies the entire agreement between GoDaddy and you as the undersigned. No modification of this release shall be of any effect unless it is made in writing and signed by both parties. I agree this release will be binding my heirs, representatives, executors, administrators or any other persons acting on my behalf or on behalf of my estate.

Translated version if provided is for convenience purposes only. To the extent of any conflicts between the English version and the translated version, the English version shall control without exception.

I represent that I have read the foregoing and fully understand its contents*.

Please initial Print Name: Date: Signature:_ Date:

Minor Model Release

*If the person signing is under the age of 18, consent from a parent or guardian is needed. I hereby certify that I am the parent or legal guardian of , named above, and do hereby give my consent without reservation to the foregoing on behalf of this individual.

Parent/Guardian’s Name (Printed)

Parent/Guardian’s Signature:

Date:

Personal Information


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