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TALENT CONSENT AND RELEASE FORM PRODUCTION COMPANY LOCATION Type the production info here... Type the location info here... PROJECT TITLE Type the project title here... I have participated as indicated
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This includes, but is not limited to: for film, TV, film, television, web/CD-ROM, video game, website, CD-ROM, video and audio on-line, audio-visual, sound radio, and any number of other media on and off-line. I further allow the production to use my name, voice or image in connection with the production of any motion picture or in connection with its promotion. I understand that the Production Company may use my image or name by my or by my agent's express and express permission. Furthermore, I further grant the Production Company, and others in its possession the same, and I further authorize other persons to use or disclose the same in whatever form and manner it may choose. Furthermore, I further authorize the production in any manner or media to use or publish any and all information, graphics, pictures or other materials contained on any of my internet webpages provided, however, that the foregoing limitation shall not apply to the distribution of said information in any print advertisement, including, without limitation, a newspaper. Furthermore, I understand that the production is prohibited from using my voice or any other characters by my express prior permission unless otherwise provided. Furthermore, I understand that the production and all related parties will, with my express prior permission, and at no additional cost to me, grant me a royalty free personal use license for all music (audio and video), music videos, pictures and images (digital or otherwise) that are the property of the production. If I have no prior permission, I will grant such license to the production Company and at its choice any other person or entity at the location and rate as it deems appropriate. I also agree to submit to all reasonable physical, documentary and written examination when requested. I also authorize and represent that I am qualified, if necessary, to act in any such capacity. The foregoing grant of rights, and any license granted herein, may be suspended at any time. I understand that the Production Company reserve the right to use or release or delete any of my appearances in the production at any time and I understand that such use may include my participation as a background cast member in another motion picture or series. I certify that the above representations are true and correct to the best of my knowledge and belief. If I have any complaint or claim against the Production Company, the Screen Credits or another person or party for any loss, damage, or cost associated with the above, I can be reached and served individually.