Actor/particpant Release Form (Page 2 of 2) in pdf

MINOR RELEASE

I have read and understand that all covenants inherent in the ACTOR/PARTICIPANT RELEASE FORM

above are applicable to this MINOR RELEASE.

In Addition:

The undersigned, being the legal parent(s) or guardian(s) of ________________________, a minor child

(hereinafter referred to as the "Child"), being of legal age and residents of the state of _____________,

do hereby consent and grant to (filmmaker) ______________________________, permission (1) to film,

take photographs and/or record the voice of the Child in connection with the video tentatively titled

_______________________________, (2) to put the finished videos, pictures, negatives, reproductions

and copies or the original prints and negatives of the Child and any sound track recordings, and

recordings which may be made of the Child's voice, including the right to substitute the voice of other

persons for the Child's voice, the Child's name, or likeness, (collectively "Tangible and Intangible Items"),

in said Picture and (3) to use said Tangible and Intangible Items in any manner deemed proper by

Trapeze School World Corp so long as such use is in connection with the exhibition, advertising,

promotion, distribution and/or exploitation of said video.

The undersigned further agree and warrant that the above!mentioned minor Child, will not disaffirm or

disavow this consent and permission on the ground that the Child was a minor on the date of execution

thereof or any similar grounds whatsoever, or endeavor to recover from Trapeze School World Corp or

any of its individual shareholders, directors, officers, employees or other associated persons, or through

any guardian, any sums for participating in the Picture.

Childs Name:

DOB:

PARENT/GUARDIAN Name:

Address:

Telephone:

Parent/ Guardian Signature: ____________________________________________ Date: ____________

Filmmaker YouTube Username:

Filmmaker E!mail address:

Filmmaker Signature: _________________________________________________ Date: ____________

Actor/particpant Release Form Page 2