P.S.A. Media Release Waiver

Simple release form:
PHOTO/VIDEO RELEASE FORM
I hereby give permission for images of my child, captured during Pro$perity Sports Association Game or Event through video, photo and digital camera, to be used solely for the purposes of
Pro$perity Sports Association promotional material and publications, and waive any rights
of compensation or ownership thereto. Release w/name or removed (includes provision to include statements... re: quotes, testimonials, etc.):

RELEASE
In consideration of the opportunity to provide certain statements and participate in photography or audio/video taping relating to certain products of Pro$perity Sports Association or its affiliated
companies (collectively, “Pro$perity LLC”), I, ______________________, for myself and, in the case of a minor (the "Minor"), for myself and the Minor in my capacity as the Minor's parent/guardian, agree as follows:

1. I hereby consent to the recording of statements, photographs, and/or audio or video
   recordings taken of the Minor or me by Pro$perity Sports Association or its contractors.

2. All statements, photographs, and/or audio or video recordings taken of the Minor or me,
   by Pro$perity Sport Association or its contractors, may be used by Pro$perity Sports Association or Pro$perity LLC for promotional, commercial or other purposes as determined by Pro$perity Sporting Association anywhere in the world in its sole discretion.

Neither the Minor nor I shall have any right to control the use or publication by Pro$perity Sporting Association of the statements, photographs, and/or audio or video recordings.

1. All statements, photographs, and/or audio or video recordings taken of the Minor or me
   by Pro$perity Sports Association or its contractors, shall be the sole property of Pro$perity Sports Association. Neither the Minor nor I shall receive any compensation in connection with use of these statements, photographs, and/or audio or video recordings for promotional, commercial or other purposes.

2. On behalf of the Minor and myself, I hereby release, waive and discharge any claims of
   any kind or nature arising out of or relating to the use of the statements, photographs,
   and/or audio or video recordings against Pro$perity Sports Association or any person or
   firm authorized by Pro$perity LLC
   to publish said materials (“Publisher”), Such
   release, waiver and discharge shall also extend to all affiliated companies, shareholders,
   directors, officers, employees, agents and assigns of Pro$perity Sport Association and any Publisher.

3. This Release shall be binding upon the Minor and me, and our respective successors,
   heirs, assigns, executors, administrators, spouse and next of kin.

4. I HAVE READ THIS DOCUMENT AND I UNDERSTAND THAT I GIVE UP
   SUBSTANTIAL RIGHTS ON BEHALF OF THE MINOR AND MYSELF (INCLUDING
   RIGHTS RELATING TO PUBLICITY AND PRIVACY WITH RESPECT TO THE
   COMMERCIAL USE OF ANY STATEMENTS, PHOTOGRAPHS, AND/OR AUDIO OR
   VIDEO RECORDINGS) AND
   I SIGN THIS RELEASE FREELY AND VOLUNTARILY.

STATEMENT
The Statement, if any, is as follows (or, indicate below that the Statement is attached to
this Release and Authorization, and attach Statement):