MEDIA RELEASE AGREEMENT

I give Core Visa Services, an immigration company, and all

affiliated companies as well, consent to use the following media submitted or acquired from you on
.

 Personal Story/Testimonial (written, verbal, and/or video)

 Photograph (digital, print, and/or negative)
 Video (including narrative and/or audio)
 Sound of Music

I understand that:

 This media no longer belongs to me and therefore now belongs to Core Visa Services and all its
affiliates.
 I can no longer change the media without the permission of Core Visa Services and all its affiliates.
 I will no longer be included in any decisions about how it will be used.
 Core Visa Services reserves the right to use the media in any way deemed suitable by Core Visa
Services (i.e. online or print). The media may also be used for promotion or advertising.
 It is not legal for me to submit a photo, story, video or song of someone else, if they are not aware of it
and have not given their consent. If a person appears in the media submitted, it is my responsibility to
have them sign a consent to release form, confirming that they understand this agreement as well.
 I must be 18 years of age or older to agree to this.

I have read this agreement and I understand it. I understand the contest rules I read.

x
Contributor

x
Witness

x
Core Visa Services Employee

WHEN MY MEDIA GETS USED OVER THE INTERNET, OR IN ANY OTHER FORM, I WANT TO:

Please check one:

o I want to stay anonymous. Please do not include my name.
o Let people know who I am. Please include my full name.
o Be identified as: