Music Video Extra Waiver & Release Form

Extra's Full Name

Date of Birth

Address

Phone Number

Email Address

Waiver & Release

I, the undersigned, understand and agree that by participating as an extra in the production of the music video titled:

Project Title

I hereby grant the producers and their assigns full permission to use my name, image, likeness, voice, and performance, in whole or in part, in any and all media, now or hereafter known, worldwide and in perpetuity, without restriction or compensation. I hereby waive any right to inspect or approve the finished product or any material in which my likeness appears.

I release and hold harmless the producers, its officers, agents, and employees from any and all claims, demands, and causes of action, including but not limited to personal injury or property damage, arising out of my participation in this production.

Date(s) of Production

Extra's Signature

Date Signed

Parent/Guardian Consent (If Under 18)

I am the parent or legal guardian of the minor named above. I have read and understand this waiver and release and consent to the terms and conditions on behalf of the minor participant.

Parent/Guardian Name

Parent/Guardian Signature

Date