I hereby grant and authorize The Little Pie Company, Ltd., a New York corporation, having an address at 424 West 43rd Street, New York, NY 10036 (hereinafter, “Little Pie”) the right to take, receive, edit, alter, copy, exhibit, publish, distribute and make use of any and all pictures, videos, likenesses or images (in any form, whether print, .jpeg, .tiff, .pdf, .jpg or the like) taken of me or given by me to Little Pie (hereinafter such pictures, videos, likenesses or images of the undersigned shall be referred to collectively as the “Image”) to be used in Little Pie’s media, promotional and advertising campaign known as “American as Apple Pie” in any promotional materials promulgated or disseminated by Little Pie, including (without limitation) websites, social media and email campaigns, e-newsletters, flyers, posters, photos, e-brochures, advertisements, annual reports, press kits, submissions to journalists, websites, “email blasts”, social networking sites and all other print and digital communications, whether now in existence or hereafter created. I waive the right to inspect or approve any editing of my Image or finished product in which my Image appears, in any form, including written or electronic copy.

The foregoing consent and authorization for the use of the Image: (A) is without payment or any other consideration (other than an Apple Pie); (B) extends to all languages, media, formats and markets now known or later invented or discovered; and (C) shall continue indefinitely and is irrevocable. I understand and agree that my Image and all related materials shall become the property of Little Pie (or any successor or assigns of Little Pie) and will not be returned to me.

I acknowledge and agree that I have NOT been compensated for this use of my Image, other than receiving an Apple Pie as a token of appreciation. I hereby waive any right to royalties or any other type of profit, payment or compensation arising or related to the use of any and all Images.

I hereby hold harmless and release Little Pie from all liability, petitions, and causes of action in relation to my Image that I, my heirs, representative, executors, administrators, or any other persons may make while acting on my behalf or on behalf of my estate.

I acknowledge and confirm that (i) I have made the foregoing grant and authorization (in the 1st and 2nd Paragraphs) and (ii) I have made the foregoing waiver and release (in the 3rd and 4th Paragraphs) with the full understanding that all of the foregoing will be binding on me in the future, even if my Image would in the future become valuable were I to be at such time a famous celebrity, actor, model, politician, etc.. (or other type of “Public Figure”).

I represent and warrant that: (a) I am eighteen years of age or older, fully “emancipated” and of “full age” in the State or Country in which I reside; (b) I am of sound mind and under no constraint or undue influence; (c) I have read and understand the contents of this Consent; and (d) I have every right to execute this Consent and I do so willingly and without any coercion or undue influence; and (e) I have read the above Consent prior to its execution and am fully familiar with its contents. This Consent shall be binding upon me, and my respective heirs, legal representatives, and assigns.

By clicking “I Agree” at the bottom of this page I confirm that I have read the above Consent, am fully familiar with its contents and agree to all of the above provisions.

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