Effective as of the date shown below, approval for past use and permission for present and future
use is being granted to Meraki Tribe Magazines, 111 Professional Plaza, Neenah, Wisconsin
54956 to use photographs or other images taken of Minor Model (the
Guardian Party), as more fully explained in this Consent and Release.
For value received, receipt of which is hereby acknowledged, the Guardian Party hereby
grants consent to Meraki Tribe Magazines, its agents, employees, licensees, and successors in
interest (collectively, the Released Party) and authorizes the use of any and all photographs taken
of them, and any reproduction of them in any form in any media whatsoever and in any derivative
work based thereon throughout the world, and to use them to publicize, promote and advertise,
including but not limited to use for point of sale advertising.
The Guardian Party also consents to the use of their own name or any fictitious name which
may be chosen in connection with the aforesaid photographs.
The Guardian Party hereby releases any and all claims whatsoever in connection with the use
of their photograph and name and the reproduction thereof as aforesaid.
The Guardian Party hereby waives any right that they may have to inspect and/or approve the
Magazines or the advertising copy that may be used in connection therewith or the use to which it may
THE GUARDIAN PARTY WARRANTS THAT THEY ARE THE UNDERSIGNED AND
THAT THEY HAVE READ THIS CONSENT AND RELEASE PRIOR TO THE SIGNING OF
THIS DOCUMENT, THAT THE UNDERSIGNED UNDERSTANDS IT, AND THAT THE
UNDERSIGNED FREELY ENTERS INTO THIS CONSENT AND RELEASE.
I have agreed to submit this release form by electronic means. By signing this release form electronically, I certify that: