VIDEO APPEARANCE RELEASE FORM

FOR GOOD AND VALUABLE CONSIDERATION, the receipt and sufficiency for which is hereby acknowledged, I hereby grant to Legion M Entertainment, Inc. (“Company”) and to its licensees, assignees, and other successors-in-interest all rights of every kind and character whatsoever in perpetuity in and to my performance, appearance, name, and/or voice, and the results and proceeds thereof (the “Performance”) in connection with the footage being filmed at Sundance 2019, currently entitled “Legion M Sundance 2019 Content” (the “Projects”), and I hereby authorize Company to photograph and record (on film, tape, or otherwise), in visual, audio and spacial formats (or any other format) the entire Performance; to edit same at its discretion and to include it with the performance of others and with sound effects, special effects and music; to incorporate same into Project or other program or not including without limitation for use on any social media or other media platform; to use and to license others to use such recordings and photographs in any manner or media whatsoever; including without limitation unrestricted use for purposes of publicity, advertising, and sales promotion of the Projects; and to use my name, likeness, voice, biographic, or other information concerning me in connection with the Project, commercial tie-ups, merchandising, and for any other purpose.  I agree that Company owns all rights and proceeds of my services rendered in connection herewith as a work made for hire.

Please fill out the form below to submit your electronic release: