**I grant to Operation Warm permission, with respect to the video recordings, sound recordings, film, photographs, biographical information, and and/or images (collectively “Materials”) that Operation Warm and/or its agents and partners have taken of me:

(1) To copyright (in Operation Warm’s name or any other name selected by Operation Warm), use, re-use, exhibit, distribute, and publish the Material in whole or in part, individually or in conjunction with other materials in any existing or future medium, throughout the world, without restrictions or limitations, and without further payment, for any purpose that Operation Warm deems appropriate.

(2) To license the Material, in whole or in part, to others as Operation Warm deems appropriate.

(3) To use my name, likeness, voice, and biographical information in connection with use of the Materials if Operation Warm chooses.

All the permissions and releases that I grant shall be effective throughout the world and apply to Operation Warm and its employees, volunteers, partners, sub licensees, and agents. This Photo/Story Release Form and any disputes relating to it or the Materials shall be governed by the laws of the State of Pennsylvania, United States of America, and shall be resolved within the State of Pennsylvania. I release Operation Warm, anyone working for it or on its behalf, and any sub licensees, from any and all liability, claims, and causes of action that I might have against it arising out of the recording and/or use of such Materials.**