Name of Parent or Guardian *

First Name

Last Name

Name of Child in Production *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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DECLARATION *

I declare that the name, likeness and/or voice of my child appears in, or has been made part of, the video entry entitled 44 Filmworks Commercial Content submitted by 44 Filmworks in the Contest (the “Entry”).

FULL RELEASE AND GRANTING OF PERMISSION *

I hereby grant 44 Filmworks, its successors, its owner, its legal representatives, its clients, and its assigns, and those acting with its authority and permission, the unrestricted right and permission to copyright, license, use, reproduce, and distribute the video footage in which I am recorded in, may appear in whole or in part, composite or distorted in character or form, in any country, at any time, in any media, for any purpose. Such permissible use may include but is not limited to: commercial use, personal use, advertising, trade, exhibition, competition, promotion, marketing, video, print, publication, or editorial work. I hereby irrevocably consent to the use of my name and likeness, including my performance, voice and image in any form, as incorporated in the Entry, by 44 Filmworks, its parents, affiliates, subsidiaries, related companies, successors, licensees or designees and others acting on its behalf for the purpose of advertising and promotion in any media, throughout the world in perpetuity, including but not limited to, on the world wide web. If I contributed to creating the Entry, in any manner, I hereby irrevocably consent to all of the above.

OWNERSHIP AGREEMENT AND WAIVER *

I agree that 44 Filmworks shall own all right, title and interest to the Entry (including all content and all rights embodied therein) and that it may exploit, edit, modify, and distribute the Entry, without limitation, and without compensation, further permission or notification to me. I hereby waive any inspection or approval of use. I also waive and release 44 Filmworks and it’s owner from any claims based upon invasion of privacy, right of publicity, defamation, false endorsement, or claim of visual or audio alteration or faulty mechanical reproduction. No promise or representations of any kind have been made to me.

RIGHTS AND ROYALTIES *

I forgo and deny any rights to payment or royalties from any edited content, video content, derivatives, broadcasts, streamings, or display of any kind that may feature or contain video or audio footage of me.

COVID-19 *

I agree to follow all social distancing protocols and to wear a mask, when possible during filming, during the film production I am a part of. I agree to maintain good hygiene and to notify the director of the production if I am experiencing any symptoms related to Covid-19. I acknowledge and agree that I am not experiencing any symptoms related to or similar to those of Covid-19 as of signing this document, nor have I received a positive Covid-19 test or a doctor’s diagnosis stating that I have Covid-19 in the past 30 days.

AGREEMENT *

I acknowledge, accept, understand, and agree with the terms and conditions of this model release.

Today's Date

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