Video Release Signature Page

Video Rights Assigned to


Location Date and Time





Name of Person Being Recorded







I have participated as indicated in the above video project (the “Project”). In consideration of my appearance in the Project, and without any further consideration, I hereby grant permission to   ("Company") to utilize my appearance in connection with the Project in any and all manner and media and all rights of every kind and character whatsoever in perpetuity in and to my performance, appearance, name and/or voice and the results and proceeds thereof (the “Performance”) in connection with the Project, and I hereby authorize Company to photograph and record (on film, digital, video, tape, or otherwise), the Performance; to edit same at its discretion and to include it with the performance of others and with sound effects, special effects and music; to incorporate same into the Project or other program or not; to use and to license others to use such recordings and photographs in any manner or media whatsoever, including without limitation unrestricted use for purposes of publicity, advertising and sales promotion; and to use my name, likeness, voice, biographic or other information concerning me in connection with the Picture, commercial tie-ups, merchandising, and for any other purpose. I further acknowledge that Company owns all rights to the results and proceeds of my services rendered in connection herewith. I agree that my participation in the Project may be edited in the sole discretion of Company. I consent to use of my name, likeness, voice and biographical material about me in connection with Project publicity and related institutional promotional purposes. I expressly release Company, your agents, employees, licensees and assigns from and against any and all claims which I have or may have for invasion of privacy, defamation or any other cause of action arising out of production, distribution, broadcast or exhibition of the Project.

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Signed by Production Manager
Signed On: April 27, 2021

Signature Certificate
Document name: Video Release Signature Page
lock iconUnique Document ID: 5b20040c4a5c2a154e548965e937cbb466bc00df
Timestamp Audit
April 27, 2021 7:21 am PDTVideo Release Signature Page Uploaded by Production Manager - IP