Release Form

I hereby acknowledge that I am participating in a motion picture being produced by Rāngai.

Form requested by *

Filming Date *

Production Title

Release provided by: First Name *

Release provided by: Last Name *

Phone

Shoot Release: I irrevocably grant to the Rāngai Producer and Rāngai, its licensees, agents, successors and assigns, the right (but not the obligation), in perpetuity throughout the world and in all media now or hereafter known, to use my appearance and recordings in any manner it deems appropriate and without limitation. *

I grant the same rights in respect of any musical compositions performed or provided by me.

I grant the same rights in respect of any location or property provided by me.

Signature (type your full legal name) *

Name of parent/guardian (if under 18)