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Background Extras Release Form

By filling out the form below, you agree to the following:

I hereby give and grant Terry Goofy Jones and their respective licensees, successors and assigns (herein collectively the "licensed parties"), the right to use, publish and copyright my picture, likeness, voice, performance and action in advertising and promotion of a movie, tentatively titled DA KICKBACK (a film project) throughout the Universe and in perpetuity.


I agree that all photographs, films or recordings of me used and taken by the licensed parties are owned by them and that they may copyright material containing same. If I should receive any print, negative, or other copy thereof, I shall not authorize its use by anyone else and will use it for self-promotional purposes only.


I agree that no photograph, footage or other material need be submitted to me for approval, and the licensed parties shall be without liability to me for any distortion or illusionary effect resulting from the use of my picture, portrait, performance, voice or likeness.


I hereby waive the right to receive any payment whatsoever for my on-camera appearance, or for any other materials or services provided by myself for the above-mentioned purpose.


Nothing herein will constitute any obligation on the licensed parties to make any use of the rights set forth herein.


Thank you!

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