Photographer | Cinematographer | Historic Sandy, Utah, USA

Appearance Release Form

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date

YYYY

Session name

Please add the name of the session which will be used as an ongoing reference in our archive.

Appearance Release Form

I hereby authorize Mark Thompson Media, its representatives, successors, agents, employees, producers and directors acting in their behalf, to record a film, videotape, still photograph or otherwise use my name, likeness, image, voice and appearance for use in any Commercial and/or Program. They may edit such recordings or films as desired and may use and authorize others to use the Program(s) or portions thereof or excerpts there from, for unlimited foreign and domestic broadcast, exhibition and audio-visual use in any and all media now known or hereafter developed, in perpetuity. I understand that Producers are under no obligation to incorporate my appearance in the Program. It is understood that my participation is without compensation. I represent that I have the right to enter into this Agreement and that my appearance and the rights I have granted hereunder will not conflict with or violate any commitment or understanding I have to or with any other person or entity. I expressly release Mark Thompson Media, its representatives, successors, agents, employees, producers and directors from all claims arising out of the breach of any covenant or warranty I have made herein.

Parent or guardian

I represent that I am a parent or guardian of the minor who has signed the above Release and I hereby agree that we shall both be bound thereby.