PERSONAL RELEASE FORM TEMPLATE

Personal Release

In consideration of your permitting me to appear in the theatrical motion picture now entitled _________________________________ (the “Picture”) and for good and valuable consideration (the receipt and sufficiency of which I hereby acknowledge), I hereby grant to you the universal and perpetual right to use, and to grant others the right to use, my actual or simulated likeness, photograph, voice, personal characteristics and other personal identification in all manner and media whatsoever in, and in connection with, the Picture and any other productions; provided, however, that the rights granted to you herein shall not permit exercise of these rights as a direct commercial endorsement by me of any product or service (other than the Picture) without first obtaining my consent.

I hereby release you from all liability and obligation to me of any and all nature whatsoever arising out of or in connection with the exercise of the rights granted above, including, without limitation, from any liability for violation of rights of privacy, publicity, defamation or any similar right. I hereby indemnify you against all claims, liability and expense respecting this Release. I agree that I shall be entitled to no additional consideration as a result of the exercise of the rights granted herein and that you may rely upon this letter in preparing and exploiting the Picture and any other production.

The word “you” as used herein shall mean ____________________________________ and its successors, assigns and licensees. (Producer)

Dated:

[Signature]

[Print Name]

(If the above signatory is under the age of 18 years, the parent or legal guardian of such person should sign below.)

I hereby warrant that I am the parent and/or legal guardian of the person who signed the foregoing agreement, that I have caused said person to execute said agreement, that I will indemnify you against all claims, liability and expense respecting said agreement, and that, knowing of your reliance hereon, I agree to cause said person to adhere to all of the provisions of said agreement.

Dated:

[Signature]

[Print Name]