ENDORSER’S CERTIFICATE

1.         For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I hereby grant to ______________, its agents, and others working for it or on its behalf (including, without limitation, __________), and their respective licensees, successors, and assigns (collectively, “Client”) the unlimited right and permission to use, distribute, publish, exhibit, digitize, broadcast, display, reproduce, and otherwise exploit my name, signature, picture, likeness, voice, and biographical information, and any statements by or concerning me in the attached script (the “Statements”), and any material based thereon or derived therefrom, together with any actual or fictional material, or to refrain from so doing, in any manner or media whatsoever (whether now known or hereafter devised) anywhere in the world in perpetuity for the purposes of advertising or trade in promoting and publicizing Client and its products and services.

2.         I shall have no right of approval, no claim to compensation, and no claim (including, without limitation, claims based upon invasion of privacy, defamation, or right of publicity) arising out of any use, blurring, alteration, distortion, illusionary effect, faulty reproduction, fictionalization, or use in any composite form of my name, signature, picture, likeness, voice, and biographical information, and the Statements.  I have the full and exclusive right and authority to grant the rights granted hereunder and I agree that this Endorser’s Certificate does not in any way conflict with any existing commitment on my part.  I shall not disclose or use any information or material that pertains in any manner to this Endorser’s Certificate or any activities undertaken by Client pursuant to this Endorser’s Certificate, which is not the subject of general public knowledge, except as required by law.  I have not heretofore authorized (which authority is still in effect), nor will I authorize or permit the use of my name, signature, picture, likeness, voice, or biographical information, or the Statements in connection with the advertising or promotion of any product or service competitive to or incompatible with those of __________.  

3.         I am not a professional actor.  To my knowledge, my name, signature, picture, likeness, voice, and biographical information and the Statements have not been used in any advertising.  I certify that the Statements represent my current honest opinions, findings, beliefs, or experience.  To the extent that I suggest that I use Client’s products, I do in fact use them.  To the extent that I express a preference over other similar products, I do in fact have that preference.  I agree to notify you immediately of any change in these views.  These views were stated without any prior promise of payment or other benefit, and without any expectation of payment or benefit in return for giving my views.

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Signature

Signature of Witness

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Name (Please Print)

Name (Please Print)

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If signatory is under 21, parent or

Address

legal guardian must also sign below

to signify agreement:

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Social Security Number

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Telephone Number

Signature of Parent/Legal Guardian

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Date

Name and Address