Talent Release Form

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Talent Release Form
**Be sure to save this editable form to your computer before entering information**
I hereby give permission for_______________________________________
Community Producer or Organization
to record a presentation/ performance by ____________________________
Name of Subject
on ________________ at ________________________ in ____________
Date of Recording
Location
City, State
I also give permission for this recording to be:
• cablecast by Chicago Access Network Television (CAN TV)
• used by CAN TV and the Producer in promotional activities
• shown on other cable television systems as desired by the community
producer
_____________________________________________________________
Signature of Subject, authorized representative, or parent if under 18
__________________
Date
_________________________________
Name (please print)
_________________________________
Title (if applicable)
______________________________________ ______________________
Address
City, State, Zip
__________________
Phone number

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