Talent Release Form - Hawaii Pacific University printable pdf download

TALENT RELEASE

HPU STUDENT PROJECT NAME: ___________________________________________________

HPU Course Alpha Numeric and Title: _________________________________________________

Fall / Spring / Summer semester 20___

INSTRUCTOR'S NAME: ___________________________________________________________________

I hereby consent to the use of all images (in any format including but not limited to photographs,

videotapes, or film) taken and or/or recordings made of my voice and/or likeness made at

(RECORDING LOCATION) _________________________________________________________

on (DATE(s)) ____________________________________________________________________

by (PRODUCER(s)) _______________________________________________________________

for Hawai'i Pacific University and the HPU Student Project identified above. This HPU Student Project

is intended as an academic work and is not intended for commercial distribution or sale. Hawai'i

Pacific University may use, edit and reuse my images, voice and likeness for non-commercial

educational purposes, promotional or advertisement reasons in any and all media, now known or later

devised.

I understand that there will be no financial or other remuneration for use of my image, voice or

likeness. I waive any right I may have to inspect or approve any use of my image, voice or likeness

and hereby release the HPU Student Project and its producers and the University and its agents,

employees, successors and assigns from any liability resulting from or connected with such use.

TALENT NAME (PRINTED); ________________________________________________________

TALENT EMAIL-PHONE: ___________________________________________________________

STREET ADDRESS: ______________________________________________________________

CITY: ________________________

STATE: ________________

ZIP CODE: ____________

TALENT NAME (SIGNATURE); ______________________________

DATE: ________________

If the subject is a minor under the laws of the state where modeling, acting or performing is done,

complete the following:

GUARDIAN NAME (PRINTED): ______________________________________________________

GUARDIAN EMAIL-PHONE: _________________________________________________________

STREET ADDRESS: _______________________________________________________________

CITY: ________________________

STATE: ______________

ZIP CODE: _____________

GUARDIAN NAME (SIGNATURE):_______________________

DATE: _________________

Talent Release Form - Hawaii Pacific University