TV Series Release Form
Grant permission for your appearance and contributions to be used in a TV series production.
Participant's Full Name
*
First Name
Last Name
Participant's Email Address
*
example@example.com
Participant's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Production Company Name
*
Production Company Contact Person
*
First Name
Last Name
TV Series Title
*
Episode or Scene Description
*
Participant's Role or Contribution
*
Filming Date(s)
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Filming Location(s)
*
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Conditions or Limitations (if any)
Signature
*
Date of Signing
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Release
Submit Release
Should be Empty: