STEELTOWN ENTERTAINMENT PROJECT YOUTH & MEDIA
“TAKE A SHOT: TEEN FILM PRIZE” CONTEST
TALENT RELEASE FORM
Name of contestant(s): _______________________________________________________________________________________________________________________________________________________________________________________________________________________
School or Community-based Organization:
_________________________________________________________________________________________________________________________
Name of sponsor (Parent/Guardian, Teacher, Educator): ________________________________________________________
Date of filming: ____________________________
Length of film: ______________________________
Name of film: ____________________________________________________________________________
I, the undersigned, hereby assign all rights and release from liability the above-mentioned contestant(s) and Steeltown Entertainment Project (“Steeltown Entertainment”) for the recording, editing, exhibition, sale, and distribution of my visual image, voice and performance as embodied in footage and images used in creating the video entries for the “Take a Shot: Teen Film Prize” contest.
I agree that Steeltown Entertainment has the right to use and distribute the above-mentioned footage and video including, but not limited to, television, online, educational and commercial use and distribution. I waive any right to compensation and agree that these rights shall extend throughout the world and in perpetuity.
TALENT (Person who appears on camera). Signatures are required from each person.
PARENT/GUARDIAN PERMISSION REQUIRED IF TALENT IS YOUNGER THAN 18 YEARS OF AGE
Printed name: ______________________________________
City: ____________________State: _________ Zip:_______
Signature: _________________________________________
Date: _______________________
Parent/ Guardian Printed name: ______________________________________
City: ____________________State: _________ Zip:_______
Signature: _________________________________________
Date: _______________________
If you have any questions or requests for further information, please contact:
Jen Taormina-Lawson, Production Manager 412-251-0890 or jen@steeltown.org
Forms can be mailed to:
Steeltown Entertainment Project
2100 Wharton St, Ste. 708
Pittsburgh, PA 15203
Or faxed to: 412-251-0893