Video Shoot Release Form And Limited Liability Release Form "Fischgaard Short Film Project" printable pdf download

TEAM: ________________________ DATE: _____/______/2011

PRODUCER: ___________________ CITY: ________________

Video Shoot Release Form and Limited Liability Release Form

“Fischgaard Short Film Project”

I, _________________________, hereby acknowledge that I am participating in a motion picture being

produced by ________________________, (hereafter, Team Producer) as part of the Fischgaard Short

Film Project for _______________ (city) ___/___/2011(date).

SHOOT RELEASE: I hereby irrevocably grant to the Team Producer, and to the Fischgaard Short Film

Project, its licensees, agents, successors and assigns, the right, but not the obligation, in perpetuity

throughout the world and in all media, now or hereafter known, to use (in any manner it deems

appropriate, and without limitation) in and in connection with the motion picture, by whatever means

exhibited, advertised or exploited:

1) my appearance in the motion picture, still photographs of me, recordings of my voice taken or made of

me by it, any music sung or played by me, and my actual or fictitious name; and/or

2) the appearance of the location or property known as: _________________________, of which I am the

owner and/or manager with the power to so grant; and/or

3) the song or music, known as ______________________________________ performed by

__________________________________, for which I have the authority to grant**.

**Use of song or music by the Team Producer and/or the Fischgaard Short Film Project, is strictly limited to the film/video

referenced herein.

Furthermore, I acknowledge that the Fischgaard Short Film Project, or its assigns may shoot behind the scenes

“making of the Fischgaard Short Film Project” footage, for use in a motion picture, and I hereby irrevocably grant to

the Fischgaard Short Film Project its licensees, agents, successors and assigns, the right, but not the obligation, in

perpetuity throughout the world and in all media, now or hereafter known, to use (in any manner it deems

appropriate, and without limitation) in and in connection with the motion picture, by whatever means exhibited,

advertised or exploited: my appearance in the motion picture, still photographs of me, recordings of my voice taken

or made of me by it, any music sung or played by me, and my actual or fictitious name.

LIMITED LIABILITY: Furthermore, I understand that during my participation in the Fischgaard Short

Film Project, I may be exposed to a variety of hazards and risks, foreseen and unforeseen, that may

include, but are not limited to, personal injury, property damage and death. To the fullest extent allowed

by law, I agree to waive, discharge claims and release from liability the Fischgaard Short Film Project, its

officers, directors, employees, agents and leaders from any and all liability on account of, or in any way

resulting from Injuries or Damages. I understand and intend that this assumption of risk and release is

binding upon my heirs, executors, administrators and assigns, and includes any minors accompanying me

on the Project.

______________________________ ___________________________

Name Address

_______________________________ ___________________________

Signature

(Signature of parent/guardian if under 18)

______________________(phone)

Video Shoot Release Form And Limited Liability Release Form "Fischgaard Short Film Project"