custom video - release form template

I, the undersigned model (hereafter model) do hereby voluntarily authorize and give permission to
Company/Producer below (hereafter Producer) to the exclusive use of: photographs, video,
electronic and digital reproductions in any form of my person or personal property
From the date of execution of this General Release and Authorization, the undersigned hereto does
hereby grant, release and assign to Producer any and all claims of right whatsoever in and to all
photographs or printed materials of the undersigned or by the undersigned and delivered to
Producer for any purpose chosen by Producer.
From execution hereto and for value received and acknowledged below by model Producer shall
exclusively and irrevocably own in perpetuity all right, title and interest, including copyright, in and
to the digitized photographs, reproductions, video and any digitized printed material of the
undersigned with no rights expressly reserved by the model.
Model also grants Producer and its designees the right to use her name, likeness, image voice,
appearance, and performance as embodied in the Product whether recorded on or transferred to
videotape, film, slides, photographs, audio tapes, or other media, now known or later developed.
This grant includes without limitation the right to edit, mix or duplicate and to use or re-use the
Product in whole or part as Producer may elect. Producer or its designee shall have complete
ownership of the Product in which model appears, including copyright interests, and model
acknowledges that she has no interest or ownership in the Product or its copyright.
Model also confirms that she/he has the right to enter into this Agreement, that she/he is not
restricted by any commitments to any parties, and that Producer has no financial commitment or
obligations to me as a result of this Agreement besides the consideration already paid.
I hereby give all clearances, © {Year} {Company name}.bodied in the Product. I expressly release
and indemnify Producer and its officers, employees, agents and designees from any and all claims
known and unknown arising out of or in any way connected with the above granted uses and
representations. The rights granted Producer herein are perpetual and worldwide survive my death
and any other occurrence.
In consideration of all the above, I hereby acknowledge receipt of reasonable and fair consideration
from the Producer received and paid.