Putnam County School District

200 South Seventh Street

Palatka, Florida 32177

Standard Artist Release

I understand there is a picture being taken of me on this date __________________.
I hereby assign and authorize the Putnam County School District the right (all rights) in
and to such picture. I also authorize said producer, without limitation the right to
reproduce, copy, cable-cast, exhibit/publish, display on web page, or distribute any such
picture, and expressly waive any rights or claims I may have against your FIRM and/or
any of its Affiliates, Subsidiaries, or Assignees except as outlined in this contract.

___________________________________

Signature of Artist/Student

___________________________________

Signature of Parent/Guardian

___________________________________

Signature of Producer(s)

___________________________________

Date

PCDSB FORM E-31