Music Release Form

Music Release Form
Today's Date
MonthDayYear
Date
Film Title
Please list down below the songs that will be used
Composer/Artist
Releasor
Name
First NameLast Name
Position/Title
Company Name
Email
example@example.com
Phone Number
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Filmmaker/Producer
Releasee
Name
First NameLast Name
Position/Title
Company Name
Email
example@example.com
Phone Number
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Release
I, {name} (referred to as "Releasor"), grants permission to {name7} (referred to as "Releasee"), to use my music or audio recordings.
I understand that I may be identifiable from the reproduction of the media by the Releasee indicated herein this agreement.
I waive my rights to inspect or approve the media for a production that may be used by the Releasee for purposes stated herein, from hereon forward.
I likewise waive any right to royalties or any compensation arising from or related to the use of the image.
Signature of Releasor
Clear
Date Signed
MonthDayYear
Date
Signature of Releasee
Clear
Date Signed
MonthDayYear
Date
Should be Empty:

Composer/Artist