BeautyRox Release Form


CONSENT & RELEASE

TO: Amy King, Mary Kay Sales Director (THE “PRODUCER”)

RE: BeautyRox (THE “PRODUCTION”)

Personal Image and use section:

For good and valuable consideration, receipt of which is hereby acknowledged, I, the undersigned, do hereby grant to Producer and its affiliated companies and licensees, the irrevocable right and license to use my name and biographical material, and the right to use any audio and/or visual recording, interview or photograph made by Producer of me (and of my home or business location if included in the recording or photograph) (the “Materials”), without additional compensation to me, for inclusion in the Production and in any advertising or publicity related thereto, which may be used in any and all media now or hereafter devised, to be determined at Producer’s discretion, throughout the world, in perpetuity.

I further grant the Producer complete discretion in how it edits and uses the Materials in the Production, without changing the spirit or con
text of the content, and I hereby waive any so-called “moral rights” in connection therewith and release Producer from any cause of action, liability, loss or damage of any nature whatsoever arising out of Producer’s exercise of rights granted herein. I further hereby warrant that the rights I have granted herein and any material supplied by me will not violate the rights of any third party.

I understand that I shall not be entitled to compensation of any kind from the Producer, its licensees, successors and assigns, other than as may be specified herein.

I acknowledge and agree that Producer may assign this release without restriction.

Important additional information regarding this release:

Personal Release and Acknowledgment of Services Rendered:

I agree and understand that the beauty consultant is not a state licensed esthetician and makes no guarantees. The consultant will not be performing any type of spa treatment or therapy. What will be performed is instruction of the application of cosmetics and beauty products and skin care. I have read the above information and if I have any concerns, I will address these with the Consultant. I give my permission to the Consultant to perform the skin care procedure we have discussed and will hold her and her staff harmless from any liability that may result from this event. I understand that if I am given the opportunity to be used as a model for demonstration of techniques and application of event products that I agree to hold harmless the consultant or BeautyRox.

The terms of this Consent and Release shall be binding upon my heirs, my executors, legal personal representatives, assigns and myself.

I execute this consent and release freely and voluntarily with full understanding of its contents. I declare that am at least 18 years of age.

Parental Consent for Minors (if applicable)
I acknowledge having read the above release and I consent to its terms on behalf of my child. PARENT’S/LEGAL GUARDIAN’S
SIGNATURE (if under age of 18):

Signature Certificate
Document name: BeautyRox Release Form
Unique Document ID: 4d44d204245633eb38100c7b571b8ffbbd18d4d0
Timestamp Audit
2015-10-20 21:22:04 CSTBeautyRox Release Form Uploaded by Amy King - mkrox4amy@gmail.com IP 206.255.247.140