OTT Release Form
Use this form to provide the details needed to authorize OTT use of your name, likeness, voice, image, or submitted content for release and distribution.
Participant 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.
Role / Relationship to Production
*
Please Select
Actor
Director
Producer
Crew Member
Rights Holder
Distributor
Other
Release Scope and Content Details
Project or Content Title
*
OTT Platform or Distribution Destination
*
Please Select
Netflix
Amazon Prime Video
Disney+
Hulu
YouTube
Apple TV+
Paramount+
Max
Tubi
Other
Description of Released Content
*
Materials Being Released
*
Name
Image
Voice
Likeness
Interview Footage
Performance Footage
Submitted Media
Other
Authorization and Submission
Date of Agreement
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: