PHOTOGRAPHER S COPYRIGHT CONSENT FORM

1 Customer Name: _____ Date: _____ PHOTOGRAPHER S COPYRIGHT CONSENT form I own the COPYRIGHT in the accompanying film, print, slide, movie, artwork, CD ROM, disk, or other material (all referred to in this document as the "images") Depicting: (Describe the content of the images) I authorize Shutterfly, Inc. to reproduce the images and to deliver them to: (Customer Name): Any restrictions on the customer s use of the images are to written on this form . Please check the appropriate blanks. This release is for order number _____: Blanket use for this customer: (Shutterfly account email address) _____ One time use for the order referenced above Only the photos described above All photos by me PHOTOGRAPHER /Image owner (sign / print): PHOTOGRAPHER / Image owner address and e-mail: CUSTOMER S SUPPLEMENTAL AGREEMENT Customer represents that the COPYRIGHT owner has properly signed the above form .

2 Customer also agrees to pay the charges for processing and/or printing the photos, and to indemnify and to hold Shutterfly, Inc. and its agents for all liability, damages, and expenses (including reasonable actual attorney fees) it may incur as a result of its processing and/or printing the photos, including any claims brought by any other person claiming an interest in the photos or in their subject matter. Customer (signature): Customer address/e-mail for Shutterfly account: Accepted by: (To be signed by Shutterfly) _____ Date: _____ * Please note that in order to process this form , we will need either the order number or the email address used for the Shutterfly account written somewhere on this form .

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