I grant Permission to KUJA Studios LLC and its agents or employees to use photographs, videos, and/or audio taken from me.

These images may be used in educational and documentaries materials such as Public Service Announcements, Grant Applications, Video Documentaries, printed and online newsletters. Furthermore, I authorized the use of my images, likeness, and voice for all program promotions, materials, and any other purposes in connection with all program promotion, materials, and any other purposes in connection with the program deemed appropriate and necessary by KUJA Studios LLC.

I hear by agree to release, defend, and hold harmless KUJA Studios LLC and its agents or employees, including any firm publishing and/or distribution the finished product in whole or in part, whether on paper, via electronic media, or on Websites, from any claims, damages, or liability arising from or related to the use of the photographs/video, including but not limited to any misuse, distortion, blurring, alteration, optical illusion, or use in composite form, either intentionally or otherwise, that may occur or be produced in taking, processing, reduction, or production of the finished product, its publication, or distribution.

I am 18 years of age or older and have read this release before signing below, fully understanding the contents, meaning and impact of this release. I understand that ta I am free to address any specific questions regarding this release by summiting those question in writing prior to signing and i agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

Print Name _____________________________________ Sign Name__________________________Date__________________

Copy, Paste to your files then Sign and Email to Info@kujastudios.com