Location Release Form

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ACM
Academy for Creative Media
LOCATION RELEASE
Permission is hereby granted to:
Name: ________________________________
Title: ___________________________________
Production Number: ________________________
(hereinafter referred to as "Producer") to use the property and adjacent area located at: ______
____________________________________________________________________________
for the purpose of: _____________________________________________________________
and of photographing and recording such scenes as Producer may desire, with the right to exhibit and
license others to exhibit all or any part of said photographs and recordings in any manner Producer may
desire without limitation or restriction of any kind. Said permission shall include the right to bring
personnel and equipment (including props and temporary sets) onto said property, and to remove the
same after completion of work.
The above permission is granted by _______________________________for a period
property owner
of __________________ beginning _________________
Producer hereby agrees to hold the undersigned harmless of and from any and all liability and loss which
the undersigned may suffer or incur by reason of any accidents or other damages to said property caused
by any of Producer's employees or equipment on or about the above mentioned premises. Producer shall
leave said premises in substantially as good condition as when received, reasonable wear and tear in
accordance with this agreement excepted.
The undersigned hereby warrants that he is the owner or agent of said premises; that he is fully
authorized to enter into this agreement and has the right to grant Producer the use of said premises and
each and all of the rights herein granted.
The Producer agrees to exercise reasonable care in the use of these premises and will leave them in
substantially as good condition as when received. Projects undertaken by ACM students are for
instructional purposes only and are not intended for any form of commercial use
SIGNATURE OF PROPERTY OWNER: ____________________________________ Date: _________
SIGNATURE OF STUDENT PRODUCER: __________________________________ Date: _________
ACM Course: ________________________________________________ Phone: _________________
PLACE THIS RELEASE IN YOUR PRODUCTION BOOK --- YOU MUST HAVE A COPY AT THE FILM LOCATION
Rev 2/04

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