TESTIMONIAL FORM

Authorization and Release

I understand my testimonial as outlined below (the "Testimonial") and made on behalf of ap3 Web Development (hereinafter called "ap3") may be used in connection with publicizing and promoting ap3. I authorize ap3 to use my name, company and the Testimonial as set forth on this form.

I hereby irrevocably authorize ap3 to copy, exhibit, publish or distribute the Testimonial for purposes of publicizing ap3's programs or for any other lawful purpose. These statements may be used in printed publications, multimedia presentations, on websites or in any other distribution media. I agree that I will make no monetary or other claim against ap3 for the use of the statement.

In addition, I waive any right to inspect or approve the finished product, including written copy, wherein my likeness or my testimonial appears.

I hereby hold harmless and release ap3 from all claims, demands and causes of action which I, my heirs, representatives, executors, administrators or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.