Photographer Copyright Consent Form

Customer Name _____________________________________ Date__________________

I own the copyright in the accompanying film, print, slide, movie, artwork, CD ROM, disk or other material (all referred to in this document as the "photos") depicting: (describe the content of the photos on line below)

__________________________________________________________________________

I authorize KUSTOM KEEPSAKES, INC. to reproduce the photos and to deliver them to _________________________(customer name). Any restrictions on the customer's use of the photos are written on the front or reverse side of this form.

Check the appropriate blanks.

This release is for:

Blanket use for this customer One time use

The photos described above All photos by me

Notify me when the photos are copied: Yes No

_____________________________________________ Photographer

_____________________________________________ Address/Telephone

_____________________________________________

CUSTOMER'S SUPPLEMENTAL AGREEMENT

Customer represents that the above form has been properly signed by the copyright owner. Customer also agrees to pay the charges for processing and/or printing the photos, and to indemnify and hold harmless KUSTOM KEEPSAKES, INC. and its agents for all liability, damages and expenses (including reasonable actual attorney fees) it may incur as a result of its processing and/or print the photos, including any claims brought by any other person claiming an interest in the photos or in their subject matter.

_____________________________________________ Customer Signature

_____________________________________________ Address

_____________________________________________

_____________________________________________ Accepted By (Dealer/Lab)

LAB IS TO KEEP THIS FORM AFTER PROCESSING