Location Release

Permission is hereby granted to:

Producer/Filmaker: _________________________________________________

for the purpose of shooting the following video titled _________________________________________________________________

(hereinafter referred to as “Producer”) to use the property and adjacent area located at:

_________________________________________________________________

and of photographing and recording such scenes as Producer may desire, with the right to exhibit and license others to exhibit all or any part of said photographs and recordings in any manner Producer may desire without limitation or restriction of any kind. Said permission shall include the right to bring personnel and equipment (including props and temporary sets) onto said property, and to remove the same within ___hours after completion of work.

The above permission is granted for a period of _________________beginning ________

Producer hereby agrees to hold the undersigned harmless of and from any and all liability and loss which the undersigned may suffer or incur by reason of any accidents or other damages to said property caused by any of Producer’s employees or equipment on or about the above mentioned premises. Producer shall leave said premises in equally as good condition as when received.

The undersigned hereby warrants that he is the owner or agent of said premises; that 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.

The Producer agrees to exercise reasonable care in the use of these premises and will leave them in substantially as good condition as when received.

Signature of Property Owner: _____________________________ Date: _____

Signature of Producer/Film Maker : ________________________ Date: _____

Address _____________________________________________

_____________________________________________

Phone: _______________ e-mail: _______________________