Media Release

For the purposes of this Video & Photography Release (“Release”) “I” or “me” refers to you either as (1) an individual or (2) the owner or person responsible for the Premises (defined below) or both (1) and (2), as applicable. In consideration of the opportunity afforded to me to participate in the production, I hereby state and agree to the following: 

Name(Required)
Address(Required)
MM slash DD slash YYYY
By signing this form electronically and clicking on "Submit", you agree to the terms and conditions stated herein.

Name(Required)
Address(Required)
MM slash DD slash YYYY
By signing this form electronically and clicking on "Submit", you agree to the terms and conditions stated herein.