Download Video Recording Release Form

Photograph & Video Release Form
For good and valuable consideration I irrevocably grant to ___________ (Company Name) permission, all rights to,
in and of my name, image, likeness, sound of my voice as recorded, publicity and biographical information (the
“Materials”) and any of the associated works of authorship (including written materials or transcripts of what I say)
used in or with my recording (the “Written Materials”) on any medium in perpetuity, throughout the universe and
for any purpose related to the business of ___________ (Company Name), all royalty free. I irrevocably grant to
___________ (Company Name) the rights to copyright, edit, use, modify, copy, exhibit, display, publicly perform,
publish, broadcast, print, reprint, create derivative works from, distribute, and sell the Materials and the Written
Materials in their entirety or in any portion, in any form or medium that now exists or may exist in the future,
individually or in conjunction with other works or as a collective work, in print, audio, video, electronic, or digital
form, including but not limited to the exercise of such rights through Internet or Intranet sites, computer on-line
services, and all other electronic and non-electronic media and distribution mechanisms now known or later
developed.
I waive any right of notice, inspection or approval of the uses of the Materials or the Written Materials, including for
advertising, marketing, promotional, testimonial or other uses. Additionally, I waive any right to royalties or other
compensation arising from or related to the use of The Materials or Written Materials. I also understand that the
Materials and Written Materials may be used in diverse settings within an unrestricted geographic area.
I warrant that I am the sole owner of, or have obtained a license for, all rights in the Written Materials, that the
Written Materials do not infringe the copyright or other property rights of any third party, and that I have full power
to convey the rights granted in this Agreement.
I release and discharge ___________ (Company Name), including, without limitation, its officers, employees,
agents, and representatives, from any and all claims, demands, and causes of action that I may have against it by use
of the Materials or the Written Materials, including, without limitation, any claims based on the right of privacy, the
right of publicity, copyright, libel, or slander.
I grant to ___________ (Company Name) the right to assign or license to third parties any of the rights contained
herein.
By signing this document I acknowledge that I have completely read and fully understand the above release and
agree to be bound thereby. I am 18 years of age or older as of the date hereof, or this document bears the signature
of my parent or legal guardian.
Full Name _____________________
Address _______________________
Phone ________________
Signature _____________________
Date ______________________
If this release is obtained from a person under the age of 18, then the signature of that person’s parent or legal
guardian is also required.
Parent’s Signature_____________________________ Date___________________
1