1. Irrevocable License
and Release Re: Use of Motion Picture Product,
Image, audio and Likeness
I attest that I am at least eighteen years of age and hereby authorize, permit, and license GraceTime / The GraceTime Project to forever:
a. use, promote, license, distribute, lend, display and publish my
work in any and all media, as submitted to GraceTime (or the GraceTime
Project) and hereby release them from all liability and claims that may
arise out of the exercise of said authorization, permission, and license
b. use, separately or together, my name, picture, image, audio or other likenesses in any and all present and future media for the purposes of advertising, publicity and trade related to material submitted to GraceTime (or The GraceTime Project ). I understand that there will be no financial or other remuneration for the use of my name, picture, image, or other likenesses and hereby release GraceTime (or The GraceTime Project) from all liability and claims resulting from or connected with the publication of such work.
Movie Title, Subject, Name or purpose date submitted Location of production
Indivigual full name birth date Appointment time
Home address city,state & zip code E-Mail address
Applicant Signature date signed Telephone number
I hereby attest that I am at least eighteen years of age, have legal custody of ________________________, and consent to and execute on said minor's behalf the foregoing Irrevocable License and Release Re: Use of Motion Picture Product, Image, audio and Likeness for the use and benefit of GraceTime (or The GraceTime Project) and do so knowingly and voluntarily. I further release GraceTime (or The GraceTime Project) from all liability and claims that said minor has or may have that arise out of or relate to the execution and use by GraceTime (or The GraceTime Project) under said License.
Parent or Guardian name please print
Parent or Guardian name signature date signed