RELIEF SCIENCES LIMITED 

and AFFILIATES 

IMAGE, LIKENESS AND MEDIA USE RELEASE 

For 

PRODUCT RELATED TRIAL AND/OR TESTIMONIAL GROUP 

PARTICIPANTS 

Regarding 

SIGNAL RELIEF BRAND, JOVI BRAND AND REYA BRAND 

AND RELATED PRODUCT(S) 

The Participant hereby agrees as follows regarding the SIGNAL RELIEF BRAND, JOVI BRAND AND  REYA BRAND AND RELATED PRODUCT(S). 

1. Participant Authorization for Image and Likeness. Participant hereby grants Relief Sciences Limited  (and “Affiliates”) (all “RSL”), as well as other entities designated by RSL, including RSL representatives,  employees, independent contractors, and any affiliate and assign of each, and any person, corporation, or  entity acting under their permission or authority or for whom they might be acting (including anyone  distributing) and regarding, but not limited to, the RSL Products (currently known as the Signal Relief  (patch), the Jovi (patch),and the Reya (patch) or other similar names used by RSL for its Products (all  herein the “Products” and jointly the foregoing persons and entities referred to as the "Producers"), the  perpetual and worldwide right and permission to publish, reproduce, distribute, and/or otherwise use: (i)  the Participant’s name; (ii) any still or moving photographic, audio and/or video image or likeness of the  Participant; and (iii) any statement or endorsement (including any letter or photograph) made by the  Participant. All understood by the Participant to be the “Endorsements”, the “Testimonial(s)” and the  “Rights” granted. Participant agrees that the Producers shall also have the right to edit, alter, incorporate,  use and reuse the Endorsements in video, audio, print ads, still photographs, catalogs, packaging and  package inserts, digital media, Internet, and any/all other media (collectively, the “Advertising”), as well  as to reproduce, exhibit, broadcast, transmit, and distribute Advertising containing the Endorsements. Participant specifically understand that the Rights granted and the Testimonials may include information  provided by the Participant, or any portions thereof, in any and all present and future media for any  purpose, including the sale, publication, display, Advertising, and trade of the Products and/or any other  related RSL products and services, and with such frequency, in whole or in part, as the Producers shall  determine in their sole discretion, without further authorization by the Participant or compensation or  consideration to Participant other than as set out in this Agreement. In connection with these matters, Participant hereby perpetually and unconditionally releases each of the Producers from all associated  liability. Participant also disclaims any financial or other interest in the Testimonial(s) and further  acknowledge that the Testimonial(s), with the Advertising and Endorsements, constitute the sole property  of any one or all the Producers as the Producers shall decide amongst themselves. Participant affirms that  any statements or endorsement made in the Testimonial(s), and any related Advertising and Endorsements,  are factually accurate and represent Participant’s honest opinions, findings, beliefs, or experiences.

Participant hereby waives (unless otherwise agreed in writing by RSL) all rights of inspection or approval  with regard to any recording, taping, reproduction, proposed printed, audio or video publication and/or  other use of Participant’s name in the Testimonial(s), and the related Advertising and Endorsements.  

2. Participant Release. Participant releases and discharges the Producers from and against all liability  resulting from their use of Participant’s name and the Testimonial(s). Participant agrees that her/his/its use  and Endorsements of the Products are fully voluntary, and Participant assumes complete responsibility for  her/his/its actions in connection with such use or Endorsements. 

3. Confidential Information. If there is a “Testimonial(s) Group” or a group of similar nature, Participant understands that during her/his/its participation in a Testimonial(s) Group she/he/it may have access to  confidential information. "Confidential Information" that includes, but is not limited to: (i) any  information obtained or observed while attending a Testimonial(s) Group session conducted by or for the  benefit of the Producers; (ii) any information about or shared by a participant in the Testimonial(s) Group  and (iii) any and all information concerning the Product(s) or Producers' techniques, ideas, processes, trade  secrets, innovations, discoveries, improvements, research or developments and test results, data, strategies,  and forecasts. Participant hereby agree to maintain Confidential Information in the strictest confidence and  not use it or disclose it to any third party. 

4. Participant Products Usage. Participant understands that it her/his/its responsibility to use the RSL  Products in accordance with the instructions provided. also represents that she/he/it has reviewed all  related RSL information. Participant represents that she/he/it is not currently taking any prescription drugs  that in any way relate to use of the Products. Participant understands that the statements relating to the  Products have not been evaluated by the Food and Drug Administration and the Products are not intended  to diagnose, treat, cure or prevent any disease. Participant further understand that it is her/his/its responsibility to use the RSL Products in a safe manner and therefore releases all liability of the Producers  for any injuries she/he/it may incur through use of the Products.