EVER WONDERED WHAT A RELEASE FORM READS LIKE?

Release Form

For and in consideration of my engagement as a producer/director, photographer, actor/actress, designer, model, and/or Company/ Agency representative by__"THE VILLAGE IDIOT"_ hereafter referred to as the Author, on terms hereinafter stated, I hereby give the Author and Publisher, their legal representatives and assigns, those for whom the author and publisher are acting, and those acting with their permission, or their employees, the right and permission to publish, copyright and/or use, reuse and/or broadcast and republish pictures and features of, and by me and/company/Agency, or in which I may be distorted in character, or form, in conjunction with my own or a fictitious name, on reproductions thereof in color, or black and white received from me by the Author for the purpose of featuring and/or promoting me (the talent/company/agency) in the said book, and any purpose whatsoever that has to do with the book and promoting the book, including the use of any printed matter in conjunction herewith.

I hereby confirm

1)   That I have seen or inspected the finished feature, story and/or work, or advertising copy or printed matter that may be used in conjunction therewith or the eventual use that it might be applied.

2)   That the author has received no monies from me/the company/agency to feature me and/or the company/agency in this book.

I hereby release, discharge and agree so save harmless the author, publisher, his representatives, assigns, employees or any person or persons, corporation or corporations, acting under his permission or authority, or any person, persons, corporation or corporations, for whom he might be acting, including any firm publishing and/or distributing the finished product, in whole or in part, from and against any liability as a result of any distortion, blurring, or alteration, optical illusion, or use in any composite form, either intentionally or otherwise, that may occur or be produced in the taking, processing or reproduction of the finished product, its publication, distribution, or broadcast of the same.

I declare that I have the copy right to the pictures I have supplied and that the information I have supplied about myself and/or company/agency is true.

I hereby certify that I am (over/ below) twenty-one years of age, and competent to contract in my own name in so far as the above is concerned.

I have read the foregoing release, authorization and agreement, before affixing my signature below, and warrant that I fully understand the contents thereof.

Dated…………………………………………………..

Name…………………………………………………….

(Legal Signature)

Address………………………………………………….

Witness……………………………………………………….

(Legal Signature)

Address………………………………………………………

I hereby certify that I am the parent and/or guardian of ____________________________, an infant under the age of twenty one

Years, and in consideration of and the purpose of the terms above hereby acknowledged, I hereby consent that the feature/ story/ images which have been, or are about to published by the author and/or publisher, may be used by him for the purposes set forth in original release herein above, signed by the infant model, with the same for and effect as if executed by me.

__________________________________________________

Parent or Guardian (Legal Signature)

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Address