Employer of Record: _______________________________________________
Address: _________________________________________________________
City: __________________________ State: ___________ Zip:______________
All results and proceeds of Crewmember’s services hereunder shall constitute a work-made-for-
hire, and Filmmaker shall be considered the author thereof for all purposes and the owner
throughout the world and in perpetuity in any media or embodiment, now known or hereafter of
all the rights therein. Filmmaker shall have the right to use and license the use of the
Crewmember’s name, photograph, likeness, voice and/or biography in connection with the Film
and the advertising, publicizing, exhibition and/or other exploitation thereof. Crewmember
releases Filmmaker and Filmmaker’s assigns, licensees and successors from any claim that may
arise regarding the use of Crewmember’s name, photograph, likeness, voice and/or biography,
including any claims of defamation, invasion of privacy, rights of publicity or any similar matter.
AGREED TO AND ACCEPTED:
Crewmember___________________________________ Date__________________
Producer_______________________________________ Date__________________
If Signatory is under 18:
I represent and warrant that I am the parent or legal guardian of the minor whose name appears
above, that I have read and approve of the foregoing Agreement, and consent to its execution by
my child/ward.
____________________________________________________________________
Signature of Parent or Guardian
Printed Name
Date
St. Louis Volunteer Lawyers and Accountants for the Arts