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MEDIA RELEASE FORM

I hereby consent and authorize Ferrellgas and Blue Rhino to use my likeness or property in any image, video, audio and/or other digital media in all of Ferrellgas’s and Blue Rhino’s publications including print or web-based publications. I agree that Ferrellgas and Blue Rhino may use any and all media/content of me and/or my property with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, social media marketing and Web content. I waive any right to inspect and/or approve any draft or final product of any publication.

I hereby hold harmless and release and forever discharge Ferrellgas and Blue Rhino 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, including any claim for compensation.

I am over 18 years of age and I represent this release has been carefully read and fully understand all the provisions of this release. I am freely, knowingly and voluntarily entering into this release.