Talent Consent and Release Form

Consent and Release Form

This must be completed for all actors (this includes any identifiable people) whose voice and/or image appears in a video submitted to the League of Women Voters of Washington for their Student Video Contest. For actors under the age of 18, a parent or guardian must complete and sign this form.
I understand that an original video has been created and submitted to the League of Women Voters of Washington (LWVWA) that includes images or audio of *.

I understand that this video has been submitted to, and for participation in, the LWVWA Election Credibility student video contest. I grant full permission and authority to LVWWA and anyone authorized by the organization to use, publish, and display * image and/or voice contained in the video.

I recognize that there is no form of compensation.
Date*

MonthDayYear
Date
Title of Video Entry*
Lead Producer's Name*

First NameLast Name
Lead Producer's Email*
example@example.com
Lead Producer's Phone Number*
Please enter a valid phone number.
Actor's Name*

First NameLast Name
Actor's Date of Birth*

MonthDayYear
Date
Actor's Email*
example@example.com
Parent/Guardian's Name*

First NameLast Name
Parent/Guardian's Email*
example@example.com
By signing this form, I certify that I am legally authorized to grant the permissions and waivers stated.
Signature

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