Movie Application and Release Form

Talent Information Form

March 2025 Applicants
MOVIE EXTRA APPLICATION FORM

Thank you for your interest in being a movie extra! Please complete the form below with accurate information. Note that all applicants must sign 1 or 2 Non-Disclosure Agreements (NDA) before participating in the production.
Talent Name

First NameLast Name
Date Of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name

First NameLast Name
Emergency Contact Phone No.
Please enter a valid phone number.
Race/Ethnicity
Height/weight Approximately

Do You Have Reliable Tranportation to the filming?

YesNo
Transportation Will Be provided for some who are residing in the Hagerstown MD and the Martinsburg, WV areas. You are eligible within a 20-mile radius of 21740 -25411,25401. The location for the Folming is Frederick Md. E G LIMO - Boost National Artist Mgmt is a part of the supporting List of Vendors to mention if you arrive in your own vehicle before we arrive. Applicants may inform staff that you were selected by us if you choose to. We will validate you upon arrival. "to those who will contribute to gas money, I will provide our cash app etc for that upon request.
When are You available? How much notice do you need to become availableEnter Both Answers here*
Do you have any medical conditions or allergies we should be aware of?

No
If Yes to above(please specify here):
Do you have any physical limitations (e.g., difficulty walking, standing for long periods, running)

NoYes Please explain Next Line
If yes to above please explain
I understand that I will be required to sign 1 or 2 Non-Disclosure Agreements (NDAs') before participating in the production. I certify that all information provided is accurate and that I am willing to comply with the requirements of the production team.
Type a question

Yes I Understand
I certify that all information provided is accurate and that I am willing to comply with the requirements of the production team.
Yes, I Certify
Do you require scheduled breaks for religious observance or smoking?☐ No ☐ Yes (please specify):

NoYes, ReligiousYes, SmokingYes, Other, explain next line
Explanation Here
Movie Title to be entered by staff
Producer

First NameLast Name
Production Company
staff will fill in
Release Date:TBD
staff will fill in
Movie Release Form

Please fill out the following information for the movie release(s).
I, the undersigned, hereby grant permission to the Production Company and its successors, assigns, and licensees (collectively referred to as "the Producer") to use my likeness, image, voice, and performance in the movie titled above in any and all media, now known or hereafter devised, throughout the universe, in perpetuity, for any purpose, including but not limited to the following:

Theatrical Exhibition: The right to exhibit the movie in theaters, cinemas, and film festivals.Television Broadcast: The right to broadcast the movie on television, cable, satellite, and digital platforms.Online Streaming: The right to stream the movie on the internet and distribute it via online platforms.Home Video/DVD/Blu-ray: The right to release the movie on physical and digital formats for sale or rental.Promotional and Marketing Materials: The right to use my likeness, image, voice, and performance in promotional materials, including posters, trailers, and advertisements for the movie.Film Festivals and Awards: The right to submit the movie to film festivals and award competitions, and to screen the movie at such events.Educational and Non-profit Use: The right to use the movie for educational, non-commercial, and charitable purposes.
I understand and agree to the following:

Compensation: I am not entitled to any compensation, royalties, or residuals in connection with the use of my likeness, image, voice, or performance in the movie or related materials.Ownership: The Producer shall own all rights, title, and interest in and to the movie and related materials, and I have no rights of ownership or control over the Film.Release of Claims: I release the Producer, its agents, employees, and representatives from any and all claims, liabilities, or demands arising out of or in connection with the use of my likeness, image, voice, or performance in the movie or related materials.Confidentiality: I agree not to disclose any confidential information about the movie's production without the Producer's written consent.
I acknowledge that I am at least 18 years of age and have read and understood this release form before signing it.
Signature or Typed Name

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For production use only:
Application received on: ____ /____ /_________
Approved: ☐ Yes ☐ No
Notes: ___________________________________________________
Should be Empty:

Talent Information Form

Movie Release Form