Movie Release Form

Movie Title

Producer

First NameLast Name

Production Company

Release Date

Date

I, the undersigned, hereby grant permission to the Production Company and its successors, assigns, and licensees (collectively referred to as "the Producer") to use my likeness, image, voice, and performance in the movie titled above in any and all media, now known or hereafter devised, throughout the universe, in perpetuity, for any purpose, including but not limited to the following:

I understand and agree to the following:

I acknowledge that I am at least 18 years of age and have read and understood this release form before signing it.

Talent Name

First NameLast Name

Date

Signature