PARENT/legal guardian
CONSENT FORM

MINOR TALENT RELEASE AGREEMENT

For valuable consideration, the sufficiency and receipt of which is hereby acknowledged, I, the undersigned, agree as follows:

a. I consent to allow Reflective Media Productions the use of my minor child’s name, voice, image, likeness, and any and all attributes of his/her personality, in, on or in connection with any film, audio tape, video tape, audio-visual work, photograph, illustration, animation, or broadcast, in any media or embodiment, now known or unknown, including, without limitation, all formats of computer readable media, produced by or for the benefit of Reflective Media Productions. I further consent to the use of my minor child’s name, voice, image, likeness, and any and all attributes of his/her personality in any advertising or promotional material created or used in connection with Breaking Strongholds and each such item of advertising or promotional material will be considered a "Work" for purposes of this agreement.

b. I irrevocably assign to Reflective Media Productions a) any and all claims of copyright my minor child may have in and to Breaking Strongholds, and (b) the exclusive and perpetual right throughout the world to use, print, produce, publish, copy, display, perform, exhibit, transmit, broadcast, disseminate, market, advertise, sell, lease, license, transfer, modify, and create derivative works from Breaking Strongholds in any media or format, now known or unknown, for any purpose whatsoever.

c. I waive any right to inspect, examine, or approve the content of Breaking Strongholds.

d. I agree that Reflective Media Productions will have no obligation to utilize the authorizations and rights I grant to Reflective Media Production hereunder.

e. I hereby release, discharge, and agree to hold harmless Reflective Media Productions, its legal representatives and assigns, all persons acting under its authority, and those for whom it is acting, from all claims, causes of action and liability of any kind, now known or unknown, in law or in equity, based upon or arising out of Breaking Strongholds or this agreement including, without limitation, claims of libel, slander, invasion of privacy, right of publicity, defamation, trademark infringement, and copyright infringement.

f. I have read the above authorization, release and agreement, prior to its execution; I fully understand the contents thereof. This agreement will be binding upon my heirs, successors, representatives, and assigns.

g. I represent and warrant that I am the parent or legal guardian of the below named minor child. I hereby consent to the foregoing on his/her behalf.