In consideration of my or my company’s business relationship with Halliburton or other good and valuable consideration, the sufficiency of which is hereby acknowledged by me, I hereby assign to Halliburton Energy Services, Inc. (HESI) all rights, title and interest, including all copyrights, in and to any photographs, films, or videos taken of me or taken by me on the date and at the location listed below. I agree to execute, at Halliburton’s request, subsequent documents to further evidence this assignment. I grant HESI, its agents and employees permission to use any such photographs, films, or videos in media such as marketing and recruiting brochures, internal presentations or publications, and advertising materials; and to use such photographs, films, or videos in electronic versions of the same publications or on company Web sites or other electronic media.

I hereby waive any right to inspect or approve the finished photographs, films, or videos or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the photographs, films, or videos.

I hereby agree to release, defend, and hold harmless HESI, its agents or employees, including any firm publishing and/or distributing the finished product in whole or in part, whether on paper or via electronic media, from and against any claims, damages or liability arising from or related to the use of the photographs, films, or videos, including but not limited to any misuse, distortion, blurring, alteration, optical illusion or use in composite form, either intentionally or otherwise, that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution.

I am 18 years of age or older and I am competent to contract in my own name (if I am under 18 years of age, my parent or guardian will sign below as well). I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

Release Form