This is our modified template for a location release form

1. ‘Help Wanted’
LOCATION RELEASE FORM
Permission is hereby granted for:
Filmmakers name: ___________________________________________________________
(hereafter referred to as “Producer”) to use the property and adjacent area located at
for the purpose of: ___________________________________________________________
and of photography with the right to exhibit and license others to exhibit all or any part of
said photographs and recordings in any many Producer may desire without limitations or
restriction of any kind. Said permission shall include the right to bring personal equipment
(including props and temporary set materials) onto said property, and to remove the same
after completion of work.
The above permission is granted for a period of _____________ beginning ______________
Producer herby agrees to hold undersigned harmless of and from any and all liability and loss
which the undersigned may suffer or incur by reason of any activities or other damages to
said property caused by any of the Producer’s employees or equipment on or about the above
mentioned premises. Producer shall leave said premises in substantially as good condition as
when received, reasonable wear and tear in accordance with this agreement excepted.
The undersigned hereby warrants he or she is the owner or agent of said premises: that (s)he
is fully authorized to enter into this agreement and has the right to grant Producer the use of
said premises and each and all of the rights herein granted.
Projects undertaken by the Producer are not intended for commercial use.
SIGNATURE OF PROPERTY OWNER:_________________________________________
PHONE:______________________________ DATE:______________________________
FILMAKER SIGNATURE: ____________________________________________________
PHONE:______________________________ DATE:______________________________
GUARDIAN SIGNATURE (if under 18): _________________________________________
GUARDIAN NAME (Print): ___________________________________________________
PHONE:______________________________ DATE:______________________________