STANDARD MODEL RELEASE FORM
The undersigned enters into this Agreement with
______________________________________ ("Producer"). I have been
informed and understand that Producer is producing a videotape program and that
my name, likeness, image, voice, appearance and/or performance is being
recorded and made a part of that production ("Product").
1. I grant Producer and its designees the right to use my
name, likeness, image, voice, appearance, and performance as embodied in the
Product whether recorded on or transferred to videotape, film, slides,
photographs, audio tapes, or other media, now known or later developed. This
grant includes without limitation the right to edit, mix or duplicate and to
use or re-use the Product in whole or part as Producer may elect. Producer or
its designee shall have complete ownership of the Product in which I appear,
including copyright interests, and I acknowledge that I have no interest or
ownership in the Product or its copyright.
2. I also grant Producer and its designees the right to
broadcast, exhibit, market, sell and otherwise distribute the Product, either
in whole or in parts, and either alone or with other products, for commercial
or non-commercial television or theater, closed-circuit exhibition, home video
distribution or any other purpose that Producer or its designees in their sole
discretion may determine. This grant includes the right to use the Product for
promoting or publicizing any of the uses.
3. I confirm that I have the right to enter into this Agreement,
that I am not restricted by any commitments to their parties, and that Producer
has no financial commitment or obligations to me as a result of this Agreement.
I hereby give all clearances, copyright and otherwise, for use of my name
likeness, image, voice, appearance and performance embodied in the Product. I
expressly release and indemnify Producer and its officers, employees, agents
and designees from any and all claims known and unknown arising out of or in
any way connected with the above granted uses and representations. The rights
granted Producer herein are perpetual and worldwide.
4. In consideration of all the above, I hereby
acknowledge receipt of reasonable and fair consideration from the
Producer.
I have read the foregoing and understand its terms and
stipulations and agree to all of them:
Model's Name (Please Print)
______________________________________________
Signature of Model
___________________________________________ Date_______________________
(If the person signing is under age 18, a parent or legal
guardian must sign below.)
I hereby certify that I am the parent or legal guardian
of the model named above and I give my consent without reservation to the
foregoing on behalf of him or her.
Signature of Parent or Guardian
________________________________ Date __________________________
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