This Performer Release and Consent Form is executed by an individual who will be
appearing and performing in a music video. This document provides the individual's
consent to the music video producer to videotape and reproduce the performance of the
individual and releases the other party of any claims that may arise in connection with
the performance. The form contains numerous standard provisions and may be
customized to fit the specific needs of the contracting parties. This document should be
used by music video producers and performers in music videos.
PERFORMER RELEASE AND CONSENT FORM FOR MUSIC
THE UNDERSIGNED _________________ [NAME OF PERSON OR PARTY WHO
IS GIVING THE PERMISSION, i.e., THE ARTIST/PERFORMER] (the “Releasor”)
hereby grants permission to ________________________ [NAME OF PERSON WHO IS
GETTING PERMISSION] (the “Releasee”) to videotape and record the performance by the
Releasor in the music video entitled _________________ (the “Video”) which is scheduled to be
videotaped and recorded on the ___ day of __________, 201____ at the following location(s):
(a) _____________________________; and
THE RELEASOR acknowledges and agrees that the Releasor shall not use the
videotaped and recorded performance for any other means save and except for the use by the
Releasor for his/her own home personal use. The Releasor further acknowledges and agrees that
he/she shall not use the videotaped and recorded performance for the promotion, advertisement
or exploitation of the Video. The Releasor acknowledges that the Releasee is the sole owner of
the rights, title and interest in and to the Video.
THE RELEASOR HEREBY RELEASES THE RELEASEE and the Releasee’s heirs,
executors, licensee, successors and assigns from any and all claims, liabilities, demands, actions,
causes of action that the Releasor has or may have in connection with the Releasor’s
performance in the Video.
THE RELEASOR HEREBY FULLY UNDERSTANDS the effects of executing this
Release and does so of his/her own free will.
EXECUTED this ____ day of ________________, 201____.
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