PRODUCTION TITLE: INCOGNITO

DIRECTOR: BARRY TURI

PRODUCER: BARRY TURI

ACTOR RELEASE FORM

To whom it may concern,
I (undersigned) hereby grant to Pulp Studios the right and authority to photograph and record
my voice, performances, actions and appearances, and use my picture, photograph and other
reproductions in connection with the marketing and student motion picture entitled Incognito.
I hereby grant to the director Barry Turi and the production company Pulp Studios, its
successors, assigns and licenses the perpetual right to use all still and motion pictures, and the
right to use my name in connection with the production, distribution and exhibition of the
motion picture short film. I further give permission to reproduce in any manner whatsoever
any recordings of me in the motion picture.
I agree that I will not assert or maintain against Pulp Studios, your successors, assigns and
licenses, any claim, action, suit or demand of any nature whatsoever.
By my signature below, I fully understand that I will to the best of my ability adhere to the
schedule to prior of the beginning of the engagement with Pulp Studios. Additionally, I agree
to make myself available when necessary, to be a part of the production process. Should I not
be able to be available, I understand that the production company may enter into separate
agreements with other individuals.
I further acknowledge that any commitments beyond the scope and intent of this actor release
form are the sole responsibility of Pulp Studios, or its duly appointed representative.
I hereby certify and represent that I am over 16 years of age and have read the foregoing and
fully understand the terms, conditions and actions which I will need to follow.]#

Actor name: _____________________

Producer name: _____________________

Actor signature: _____________________

Producer signature: _____________________