Thursday, April 17, 2014

Talent Release Form

Talent Release Form for LynnCAMTV and a Producer
I hearby assign to ____________________________, the Producer of ___________________________, and to LynnCAMTV, the right to use my likeness, voice, name and the titles of works performed by me during my appearance on the Program ___________________, and I here by authorize the editing, reproduction, copyright, exhibition, broadcast, distribution and promotion of said Program by the producer and LynnCAMTV without limitation.
I understand that I will receive no payment for my participation in this production, and I hereby release the above-named Producer and LynnCAMTV from any claims for remuneration for any subsequent use of this Program.
I indemnify and hold harmless the above-named Producer and LynnCAMTV against any and all claims arising out of any actions or statements I make or Program material that I provide for the videotape, including, but not limited to, any claims in the nature of libel, slander, copyright infringement, invasion of privacy, or publicity right, and errors of omission. I expressly release the Producer and LynnCAMTV from any privacy, defamation, or other claims I may have arising out of broadcast, exhibition, publication or promotion of this Program.
This Section For Adults (Please Print:)
First Name:
Last Name:
Address:
City, State, Zip:
Phone (Day):
Phone (Evening):
Signature:
Date:
I further agree that the representations and agreements contained in the Release are extended to my ongoing participation in this Program.
Signature:
Date:
This Section Talent (under 18 year of age only) (Please Print:)
I warrant that I am the parent or legal guardian of the minor described below and have the full right and authority to grant this consent on behalf of such minor.
Description of video, photograph, or audio recording:

Minor's Name:
Minor's Age
Minor's Address:

Minor's City, State, Zip:
Phone (Day):
Phone (Evening):
Signature of parent or legal guardian:

Printed name of parent or legal guardian:
Address of parent or legal guardian:

Date:

I further agree that the representations and agreements contained in the Release are extended to my child's ongoing participation in this Program.
Signature:
Date:

Producer name and address:



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