Fill and Sign the Release and Authorization to Record Form

Release and Authorization to Record Picture and/or Voice On Photographs, Films, Audio and/or Videotapes Release executed on _________________ (date), by _______________________ of ______________________________________________ (street address, city, county, state, zip code) herein referred to as Releasor, in favor of _________________________________, a corporation organized and existing under the laws of the State of _________________, with its principal place of business located at ______________________________________________ (street address, city, county, state, zip code) herein referred to as Releasee. In consideration of the sum of ___________________________ Dollars ($_________), and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, Releasor, being of lawful age, hereby expressly releases Releasee, its licensees, agents, successors and assigns from all liability for claims and/or demands arising out of the agreement as set forth below. Releasor hereby authorizes Releasee to record 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 ___________________________________________________________________________ (e.g., radio and television, including cable and satellite transmissions), or otherwise, and to use and license others to use such recordings, movie and sound films, audio and 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, 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 she has read and understood the contents hereof, and that she has the right and authority to execute this release and indemnification. In witness whereof, the parties have executed this release and indemnification agreement at (designate place of execution) on the date and year first above written. ________________________________