Film & TV Crew Appearance Authorization Form
Please complete this form to authorize the use of your appearance in connection with the specified film or TV production.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Production/Project Title
*
Role or Department
*
Please Select
Camera Crew
Sound
Lighting
Production Assistant
Makeup/Wardrobe
Other
Date of Appearance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location of Appearance
*
Type of Appearance
*
On-Camera
Behind the Scenes
Both
Context or Description of Appearance
*
Permission for Use of Appearance in Media (select all that apply)
*
Broadcast (TV/Streaming)
Online Platforms
Social Media
Promotional Materials
Other
Submit Authorization
Should be Empty: