Music Release Form

Music Release Form
Today's Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
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
Format: (000) 000-0000.
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
Format: (000) 000-0000.
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
2 digit month, 2 digit day, 4 digit yearDate
Signature of Releasee
Clear
Date Signed
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Composer/Artist