TALENT RELEASE NAME, VOICE AND LIKENESS RELEASE

Talent's Full Name: (individually and collectively referred to as “Talent”)

First NameLast Name

MaleFemale

Hair Color

Eye Color

Talent's Birthdate:

Date

Parent or Guardian’s Full Name (if under 18):(individually and collectively referred to as “Parent”)

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Shoot Description:

Video Producer's Name:

Release:

By signing this release I hereby give the Producer and Assigns my permission to license the Content and to use the Content in any Media for any purpose (except pornographic or defamatory) which may include, among others, advertising, promotion, marketing and packaging for any product or service. I agree that the Content may be combined with other images, text, graphics, film, audio, audio-visual works; and may be cropped, altered or modified. I acknowledge and agree that I have consented to publication of my ethnicity(ies) as indicated below, but understand that other ethnicities may be associated with me by the Producer and / or Assigns for descriptive purposes.

I agree that I have no rights to the Content, and all rights to the Content belong to the Producer and Assigns. I acknowledge and agree that I have no further right to additional consideration or accounting, and that I will make no further claim for any reason to Producer and / or Assigns. I acknowledge and agree that this release is binding upon my heirs and assigns. I agree that this release is irrevocable, worldwide and perpetual, and will be governed by the laws (excluding the law of conflicts) of the country/state from the following list that is nearest to the address of the Talent (or Parent*) given opposite:New York, Alberta, England, Australia and New Zealand.

It is agreed that my personal information will not be made publicly available but may only be used directly in relation to the licensing of the Content where necessary(e.g. to defend claims, protect rights or notify trade unions) and may be retained as long as necessary to fulfill this purpose, including by being shared with sub-licensees/ assignees of the Producer and transferred to countries with differing data protection and privacy laws where it may be stored, accessed and used. I represent and warrant that I am at least 18 years of age and have the full legal capacity to execute this release.

If Talent is a minor or lacks capacity in the jurisdiction of residence, Parent warrants and represents that Parent is the legal guardian of Talent, and has the full legal capacity to consent to the Shoot and to execute this release OF ALL RIGHTS IN TALENT’S CONTENT.
Definitions:"ASSIGNS" means a person or any company to whom Producer has assigned or licensed rights under this release as well as the licensees of any such person or company. “CONTENT” means all photographs, film, audio, or other recording, still or moving, taken of me as part of the Shoot. “MEDIA” means all media including digital, electronic, print, television, film,radio and other media now known or to be invented.“TALENT” means me and includes my appearance,likeness and voice. “PARENT” means the parent and/or legal guardian of the Talent. Parent and Talent are referred to together as “I” and “me” in this release, as the context dictates. “PRODUCER” means photographer, illustrator, filmmaker or cinematographer, or any other person or entity photographing or recording me. “SHOOT” means the photographic, film or recording session described in this form.
This Agreement may be executed in several counterparts, each of which shall be deemed an original and all of which shall constitute one and the same instrument, and shall become effective when counterparts have been signed by each of the Parties and delivered to the other Parties; it being understood that all Parties need not sign the same counterparts.

The exchange of copies of this Agreement and of signature pages by facsimile transmission (whether directly from one facsimile device to another by means of a dial-up connection or whether mediated by the worldwide web), by electronic mail in “portable document format” (“.pdf”) form, or by any other electronic means intended to preserve the original graphic and pictorial appearance of a document, or by combination of such means, shall constitute effective execution and delivery of this Agreement as to the Parties and may be used in lieu of the original Agreement for all purposes. Signatures of the Parties transmitted by facsimile shall be deemed to be their original signatures for all purposes.

Talent or Parent’s Signature:

Date Signed

Date