Release executed on __________ (date), by __________________________________

(name), of ____________________________________________________ (address), here referred to as releasor, in favor of _____________________________ (company), a corporation organized and existing under the laws of the State of ________________, with its principal place of business located at _________________________________

 ____________________________________________ (address), here referred to as releasee.


In consideration of $ __________, receipt of which from releasee is acknowledged (or recite other consideration), releasor, being of lawful age, hereby expressly releases releasee, its licensees, agents, successors and assigns from all liability for claims and demands arising out of the agreement as set forth below.


Releasor hereby authorizes releasee to record __________ (his or her) picture and voice on photographs, films and audio- and videotapes, to edit these recordings at its discretion, and to incorporate these recordings into movie and sound films or audio- and videotapes, broadcasts (radio and television, including cable and satellite transmissions) programs, or otherwise, and to use and license others to use such recordings, movie and sound films and audio/videotapes and broadcast programs in any manner of media whatsoever, including unrestricted use for purposes of publicity, advertising and sales promotion and to use releasor’s name, likeness, voice and biographic or other information in connection therewith.


Releasor further agrees to indemnify and save harmless releasee, its licensees, agents, successors and assigns, from any and all claims and liability for damages, losses or expenses of any sort arising from the making of such recordings and their use. Releasor further acknowledges that, except for ______________ (the above-stated compensation or as the case may be) there were no promises of any compensation for such use by releasee or by anyone associated with releasee and, that releasee exclusively owns all rights to these recordings regardless of the form in which they are produced or used.


Releasor warrants and agrees that __________ (he or she) has read and understood the contents hereof, and that __________ (he or she) has the right and authority to execute this release and indemnification.


In witness whereof, releasor has executed this release and indemnity at _____________

____________________ (designate place of execution) on the date and year first above written.



____________________________________                     ______________________

Signature                                                                               Date


(Acknowledgment, if desired)