ARTIST RELEASE FORM

This will confirm that for valuable consideration, receipt of which is hereby acknowledged, I, [Name of the Artist], the artist do hereby irrevocably grant the right and license to the unlimited use of my Artwork (defined below) by Filmmaker (defined below) and their affiliated companies, successors, assigns and licensees for use and display in the Video (defined below), which Video may be displayed and/or broadcast for any purpose in any and all media now known or hereafter developed throughout the world, without limitation as to duration or frequency of use.

I hereby warrant that I am the sole owner of said art, it is my original work, that it has never been published, and that I have no contractual or other arrangements which would interfere with or prevent the above-mentioned assignment or transfer of all my right, title and interest in said material. I represent that the individual named below is the sole artist to the aforesaid original work which I have furnished hereunder.

I understand that I will retain the right to use the aforementioned work for self promotion purposes upon approval by [Name of the company].

I also agree to indemnify and hold harmless [Name of the company], and their respective [producers/members/agents/employees], against and from any and all claims, liability, loss and damage, including reasonable attorney’s fees, caused by or arising wholly or in part, directly out of my inability to prove the validity of what is stated above and to defend at my expense any litigation instituted by others against any of them resulting there from.

Name of the Piece:

Artist Name:

Email:

Signature:

Date:

Address:

Telephone:

City:

State: