RELEASE FORM FOR USE OF NAME/IMAGE/VOICE

Production Title: Attack of the Short Man

Producers: MEKWAY PRODUCTIONS


I, the undersigned, grant permission to MEKWAY PRODUCTIONS (hereby referred to as the producers) to photograph me and record my voice, performance, appearances, and use my picture (and other reproductions) of my physical likeness and voice as part of the production tentatively titled “Attack of the Short Man”. I also grant permission for their use in the film’s distribution, promotion, and exhibition.

I agree that I will not make any claim of invasion of privacy, defamation of character, or any other violation of civil rights regarding the authorised use of my physical likeness and voice in the film by the producers. I release the producers from all claims, liabilities, actions, demands, and expenses.

I hereby certify that I am 18 years of age or older and have read the preceding contractual details. I fully understand their implications and that, upon signing this agreement, I am legally bound to it.

Agreed to and accepted by:

Name: _______________

Character: _________________

Address: _______________

Tel #: _____________

Signature: _____________

Date: _______________