Individual Release Form - Revision history

Quill: Category:Legal issues

2009-07-30T16:32:51Z

← Older revision		Revision as of 16:32, 30 July 2009
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	* [[Release of Liability Forms]]		* [[Release of Liability Forms]]

			[[Category:Legal issues]]

Jonathan: /* See Also */

2007-12-02T03:08:24Z

Jonathan at 03:08, 2 December 2007

2007-12-02T03:08:09Z

← Older revision		Revision as of 03:08, 2 December 2007
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	Phone:		Phone:
	____________________________________________		____________________________________________

			== See Also ==

			* [[Release of Liability Forms]

Jonathan: /* Sample */

2006-09-18T06:32:07Z

Sample

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	Individual Release		Individual Release

	Production ~~Buscycle~~:______________		Production NAME:______________
	Shoot Location:_______________		Shoot Location:_______________
	Shoot Date:_______________		Shoot Date:_______________

Jonathan at 06:31, 18 September 2006

2006-09-18T06:31:50Z

New page

== Sample ==

Individual Release

Production Buscycle:______________
Shoot Location:_______________
Shoot Date:_______________

I have participated as indicated in the above program, which I
understand will be produced and recorded for duplication and
distribution in the United States and abroad. I agree that insofar as
I am concerned this program may be edited as desired and used whole or
in part for audio and/or visual media purposes, closed circuit
exhibition purposes, and all other broadcast and media purposes
(including internet, radio and TV stations) in perpetuity in the
United States and abroad.

I consent to publication of he program transcript in whole or in part
and also to the use of my name, likeness, voice and biographical
material around me in connection with program publicity and for
institutional promotional purposes. I expressly release the producer
from any privacy, defamation or other claims I may have arising out of
exhibition, broadcast or publication or promotion off this program.

Print Name:
____________________________________________
(please print clearly so we can spell your name correctly in the film.)

Signature:
____________________________________________
Address:
____________________________________________
____________________________________________
Phone:
____________________________________________

← Older revision		Revision as of 03:08, 2 December 2007
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	== See Also ==		== See Also ==

	* [[Release of Liability Forms]		* [[Release of Liability Forms]]