| Talent Release Form Project Title: Rainbow Project 2 Talent Name :_____________________________( please print) For value received and without further consideration or compensation, I hereby consent to the use (full or in part) of all photographs, videotapes, or DVD's, or any other medium taken of me and/or recordings made of my voice and or written extractions, in whole or in part, of such recordings or musical performance or computer files for the purposes of illustration, broadcast, commercials, website or distribution in any manor. I hereby release, discharge, and agree to save harmless NAMI and all persons acting under its permission or authority from any liability that may occur while performing or appearing in the said video, audio, photographic or computer-based production. At Port Angeles, Washington_ on date______/_____/_____ (Recording location) By Dale Knudsen (Producer) For National Alliance on Mental Illness of Clallam County, Washington (Producing Organization) Talent's signature ____________________________ Date: ____/____/____ Address ________________________________ City _____________________, State _____ Zip code _____________ Phone (___) ____-_______ Consumer (sign) (required) ____________________Date:_____/____/___ Consumer Name (print) (required) ________________________________ If the consumer is a minor under the laws of the state where modeling, acting, or performing is done: Legal guardian (sign) ________________________ Date: ____/____/____ Legal guardian (print) __________________________ NAMI of Clallam County P. O. BOX 3416 Sequim, WA 98382 |
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