Talent Release Form

Production Group:

Production:

Course Affiliation:

Location(s):

I hereby release Simon Fraser University, its Staff, Faculty and Students from any legal responsibility in relation to videotape, film, or other media materials containing my recorded image and/or voice or property. I understand that all rights as to the use of such tapes or other materials is given freely to the production group.

I hereby wave any right to inspect or approve the finished product or the copy that may be used in connection threrewith. I release and discharge Simon Fraser University, its Staff, Faculty and Students for any liability whatsoever that may occur of be produced in the taking, processing, distribution, or publication of such images and sound.

It is also understood that any such materials (video, audio, film, slides, or any other media) will be used with the intent to communicate responsibly and ethically, the subject matter contained therein.

NAME:

ADDRESS:

PHONE: (H) (W)

SIGNATURE:__X DATE:

MEDIA REFFERENCE / NOTES: