Show Preview Release Form
Please complete this form to provide your consent for participating in the show preview and the use of your likeness or performance.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Show/Production Title
*
Role or Involvement in the Production
*
Date of Preview
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Preview
*
Please select the type(s) of materials to be previewed or used
*
Video recording
Audio recording
Photographs
Written statements
Other
Please describe any special considerations or restrictions regarding your participation (optional)
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Participant Signature
*
Submit Release
Submit Release
Should be Empty: