HOMEOWNER'S RELEASE FORM

HOMEOWNER'S RELEASE FORM New York Unforgettable Rooms By Wendy Moonan I, the undersigned, agree to the use of photographic images of my residence and to the use of information about said residence in a book entitled New York Unforgettable Rooms by Wendy Moonan ("the Project") to be published by Rizzoli International Publications in Fall 2018. I have the authority and do hereby grant to Wendy Moonan and Rizzoli International Publications, their assigns and licensees, the non-exclusive World Rights to New York Unforgettable Rooms and derivations thereof throughout the world, and to use the same reproduction(s) in any advertising, publicity, or other promotional material relating to the Project. I also grant to Wendy Moonan the use of any interview statements and information about the residence for inclusion in New York Unforgettable Rooms and I hereby release and discharge the photographer, subject, and Rizzoli International Publications, and their licensees and assigns, from any and all claims arising out of or in connection to any of the images photographed or interview statements made related to my residence. NAME: SIGNATURE: DATE ADDRESS: PHONE/EMAIL: PLEASE FILL IN THE NECESSARY INFORMATION, SIGN, AND RETURN THIS FORM TO: Wendy Moonan 15 West 72nd Street #28-E New York, New York 10023 EFTA00803338