TALENT RELEASE FORM

Talent Name: [TALENT’S NAME] (the “Talent”)
Address: [TALENT’S MAILING ADDRESS]
Phone Number: [TALENT’S PHONE NUMBER]
Email Address: [TALENT’S EMAIL ADDRESS]

Producer Name: [PRODUCER’S NAME] (the “Producer”)
Production Company Name: [PRODUCTION COMPANY NAME]
Address: [PRODUCER’S MAILING ADDRESS]
Phone Number: [PRODUCER’S PHONE NUMBER]
Email Address: [PRODUCER’S EMAIL ADDRESS]

Project Name: [PROJECT NAME] (the “Project”)
Recording Location: [PROJECT RECORDING LOCATION]
Recording Date: [DATE]

I hereby authorize the Producer to record and edit into the Project and related materials my name, likeness, image, voice, and participation in and performance on videotape, audiotape, film, photograph, or any other physical or digital medium for use in the above Project or parts thereof. I agree that the Project may be edited and otherwise altered at the sole discretion of the Producer and used in whole or in part for any and all broadcasting, non-broadcasting, audio/visual, or exhibition purposes in any manner or media, in perpetuity, throughout the world.

I hereby certify that I am over 18 years of age and am competent to contract in my own name insofar as the above is concerned. I have read the foregoing release before affixing my signature below and warrant that I fully understand the contents thereof. I understand that this release is perpetual, that I may not revoke it, and that it is binding on me and my heirs and assigns.

Talent’s Signature: ____________________________ Date: _____________
Print Name: ____________________________