Photo Release Form

PHOTO RELEASE FORM

I hereby grant permission to MS GEORGE MAGAZINE to use my Photograph or my Child's Photograph on its website or in other official printed publications without further consideration. I understand that MS GEORGE MAGAZINE is a wholly owned company of PUGUA' INTERNATIONAL CORPORATION and that use of photographs will not be limited to educational and commercial purposes.

I also understand that once my image is posted on the MS GEORGE MAGAZINE website, the image can be downloaded by any computer user accessing the world wide web. There, I agree to indemnify and hold harmless from any claims the following:

+Board of Directors, Members & Staff.

PUGUA INTERNATIONAL CORPORATION

+Board of Directors, Members & Staff.

MS GEORGE MAGAZINE

I REPRESENT THAT I AM OVER THE AGE OF EIGHTEEN AND I HAVE READ THE FOREGOING AND COMPLETELY UNDERSTAND THE CONTENTS THEREOF:

Name:_________________________________________________

Date:________________________________________

Telephone:___________________________________________

Signature:___________________________________________________