To: Make It Right, The Series, Inc. & The City of TorontoDate:

Name (PLEASE PRINT):______

Home address:______

Persons for whom permission is being given (If under 16 Years of age):

______

______

______

I understand that my likeness and voice are being filmed and recorded (the “Recording”) and photographed (the “Photographs”) by both the City of Toronto and Make It Right, The Series, Inc. (the “Producers”) in connection with the production and filming of a television series currently entitled “Holmes Makes It Right” (the “Production”). For good and valuable consideration, the receipt and sufficiency of which is acknowledged by me, I irrevocably agree with Producers as follows:

1.The Recording, the Photographs, the Production and the other results and proceeds of my appearance in the Production are the property of the Producers and I hereby assign, set over, and transfer to the Producers all right, title and interest I may have in or to the same, and hereby irrevocably waive any and all moral rights I may have in or to the same.

2.The Producers may and may authorize others to: (i) produce, broadcast, distribute, advertise, promote, publish, merchandise and otherwise use or exploit the Recording, the Photographs and/or the Production, in whole or in part, in any languages and in any manner, format and media now or hereafter known, throughout the universe and on an unlimited number of occasions, and (ii) use my name, likeness and/or biographical materials in or in connection with the foregoing. The Producers may also edit, adapt, add to and make such other changes and creative choices in connection with the use or exploitation of the Recording, the Photographs and/or the Production, as the Producers may decide in its sole and absolute discretion.

3.For greater certainty, I acknowledge that the rights of the Producers set out above include, without limitation, the right to use, and the right to authorize others to use, the Photographs, the Recordings and/or my name, likeness or biographical material, in whole or in part, in or in connection with: (i) the production of one or more publications of any kind (the “Publications”) and/or items of merchandise of any kind (the “Merchandise Items”) relating to the Production and/or Mike Holmes; and/or (ii) any promotional, advertising, sponsorship or endorsement activities of Mike Holmes,the Producers, or any of its affiliates, parent or subsidiary corporations or organizations as well as in City of Toronto publications/material, including marketing and promotional materials, and the City of Toronto official website, both now and in the future.

4.I represent that any statements made by me as part of my appearance in the Production are, to the best of my knowledge, true and that such statements and the other results and proceeds of my appearance in the Production will not violate or infringe upon the rights of any third party. I acknowledge that there is no guarantee that the Producers will use any portion of the Recording or the Photographs or the other results and proceeds of my appearance in the Production.

5.I unconditionally remise, release, and forever discharge the Producers, its directors, shareholders, employees, successors, assigns, licensees and any corporations related directly or indirectly to the Producers or its directors, shareholders and employees, from any and all claims, actions and demands which I (or my heirs, executors, administrators or assigns) may now or in the future have based on or arising out of or relating to the Production and/or any use or exploitation of the Production, the Recording, the Photographs, the Publications and the Merchandise Items and/or any use of my name, likeness, voice or biographical materials.

ACCEPTED AND AGREED TO:

SIGNED, SEALED AND DELIVERED )

in the presence of )

)

)

)______

Witness )[Owner Name]