CHECKS YOUR WAY, INC.

Photography/Artwork/Image RELEASE FORM

Photographer/Artist's Name:  ______________________________________________

Description of Photo/Artwork/Image:  _______________________________________

______________________________________________________________________

I, the Undersigned, hereby consent without further consideration or compensation that the photograph, artwork, or image(s) described above may be used by (Your Name/Client's

Name Here) _____________________________________________ for reproduction by Artistic! Check Products, Checks Your Way, Inc. and its associates; if any.  I hereby grant permission to Artistic! Check Products for affiliated processing of this request, as well as authorization to Checks Your Way, Inc. to crop, screen, or alter the photograph, artwork, or image for use on the items being produced including checks, labels, checkbook covers, mousepads, and/or T-Shirts.

These items are expressly for the personal use of (Your Name/Client's Name Here)

_____________________________________________, and are not to be used or distributed for his or her profit.

Signature:  ______________________________   

Date:  _______________

* Disclosure MUST BE RETURNED with your Check Order & Payment!! *