release form

1. SHORT FILM RELEASE FORM
Name of Short Film ("the Film") ………………………………Numb……………………………….
Name of Production Company/Organizers
…………………half-moon entertainment…………………………………………………………………………
Date of filming ..............................07/01/2017..................................................................................
Name of Contributor …………………………Ocean Atlantic…………………………………………………
Contact Number of Contributor …………07596843280……………………………………………………
In consideration of the Organizer agreeing that I contribute to and/or participate in the Film, the nature
and the content of which has been fully explained to me, I consent to the filming and recording of my
contribution to and/or participation in the Film subject to the terms and conditions specified below.
Signed by Contributor …………s.moore………………………………………………………………..
Dated……………………06/01/2017…………………………………………………………………………..
If the Contributor is 18 or under this form must be signed by a Parent or Legal Guardian.
I consent to [name of Contributor] entering into this agreement.
Signed by Parent or Legal Guardian
........................e.lothian.......................................................
Dated ...................................................12/01/2017.................................................................................