Video Producer Portfolio Release Consent Form
Use this form to record permission for using a subject’s image, voice, likeness, and recorded performance in a video producer’s portfolio and promotional materials.
Subject Information
Full Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Project Identification
Project Name or Video Title
*
Recording/Session Date
*
-
Month
-
Day
Year
Date
Portfolio Release Permissions
Restrictions or Approval Preferences
No restrictions
Approval required before public posting
Approval required for social media only
No use in paid advertising
Limit use to portfolio and showreel only
Other
Notes or special instructions
Acknowledgement and Signature
Signature
*
Date Signed
-
Month
-
Day
Year
Date
Submit Form
Submit Form
Should be Empty: