Talent Release

TALENT RELEASE for the MORE THAN JUST MUD MiNiFLiCK Contest

You must submit this form if you use actors and/or their voices in your film. I _________________________________________ hereby agree to participate on camera and/or in voice-over for the film __________________________________________ made by _____________________________________ for the Raincoast Education’s “More Than Just Mud” MiNiFLiCK Contest. I hereby authorize the Raincoast Education Society, its employees, representatives and assigns, the right to use, reproduce, edit, publish or distribute my image, likeness, and/or voice on the film, in perpetuity, for the purposes of education, information and promotion, without compensation to me. By participating in this film, I voluntarily assume any and all risks that are known and unknown. To the fullest extent allowed by law, I waive any right to seek damages or compensation from the Raincoast Education Society or filmmaker(s) as a result of my participation in this film.

________________________________________ Date: _________________________________ (Signature) _______________________________________ (Printed name) E-mail: __________________________________ Phone: ________________________________ Address: _______________________________________________________________________

If Signatory is under 18: I certify that I am the parent or guardian of the minor whose name appears above, that I have read, understood, and approve of the conditions of this Release, and consent to its execution by my child/ward. I hereby guarantee completely, my child’s/ward’s Release as set forth above. ________________________________________ Date: _________________________________ (Signature of Parent or Guardian) _______________________________________ Phone: ________________________________ (Printed name) Address: _______________________________________________________________________

This contest is sponsored by the Raincoast Education Society with funding from the Habitat Conservation Trust Fund.