Parent’s Name(s):_________________________________________________________________________________________________

Address:___________________________________________________________________________________________________________

E-mail:______________________________________________ Phone:(______)______________________________________

Please list children’s names from left to right, as they appear in the photograph. Please print legibly.

Name:_____________________________________________________________________________________________________________

Age:__________Relationship to other children:_____________________________________________________________________

Name:_____________________________________________________________________________________________________________

Age:__________Relationship to other children:_____________________________________________________________________

Name:_____________________________________________________________________________________________________________

Age:__________Relationship to other children:_____________________________________________________________________

Name:_____________________________________________________________________________________________________________

Age:__________Relationship to other children:_____________________________________________________________________

Name:_____________________________________________________________________________________________________________

Age:__________Relationship to other children:_____________________________________________________________________

I/we hereby grant Fuling Kids International, its director, members, agents, contractors and representatives (collectively "FKI") the absolute and irrevocable right, and consent, to the filming, taping, reproduction, use, reprinting, publication and distribution of the photograph(s), identifying information and comments submitted herewith (in whole or in part, in original or modified form) for use in, and with respect to, FKI’s 2013 Calendar and all related projects and/or any publicity, promotion, or marketing related thereto and hereby assign to FKI all rights, title, and interest in and to the photograph(s). I/we understand and agree that I/we hereby release and discharge FKI from any and all claims, causes of action, demands, liabilities, losses, costs, expenses and/or damages whatsoever arising out of, or in connection with, any act or omission related to the use or publication of the photograph(s), information, comments and/or the Calendar, including without limitation, all claims for libel, invasion of privacy, injury to any person or photograph. This Release shall be governed by Washington law without regard to choice of laws. I/we represent that I/we am the lawful guardian/legal parent of the child(ren) for whom this Release is submitted.

Signature (Parent 1):________________________________ Signature (Parent 2):_________________________________________

Printed Name:______________________________________ Printed Name:_______________________________________________

Date:________________________________________________ Date:_________________________________________________________

Child(ren)’s Name(s):_____________________________________________________________________________________________

Group shots MUST include a SEPARATE release form for each family. Both parents must sign if applicable.

For valuable consideration received, I, on behalf of the undersigned studio, all affiliates, franchisors, myself, employees, employer, successors and predecessors in interest, agents, representatives (collectively, "Photographer") hereby grant, assign and convey to Fuling Kids International, its director, members, agents, contractors and representatives (collectively "FKI") all rights, title and interest in and to the photograph(s) taken by the Photographer of the child(ren) identified herein for use, publication and reprinting in FKI’s 2013 Calendar and related projects and any advertising or promotion thereof (the "Calendar") without compensation to Photographer and hereby authorize FKI to use and publish the name of the Photographer in the Calendar. Photographer hereby releases and discharges FKI from any and all claims, causes of action and demands arising out of or in connection with the use or publication of such photograph, including without limitation, any copyright claims. The undersigned represents and warrants to FKI that he/she is authorized to execute this consent on behalf of Photographer and has the capacity to contract in her/his own name of Photographer.

Studio Name:_____________________________________________________________________________________________________

Address:_______________________________________________City:___________________________State:_______Zip:__________

Telephone:(______)_________________________________Email:________________________________________________________

Signature:_________________________________________________________________________________________________________

Printed Name:_________________________________________________________________Title:______________________________