MUSIC RELEASE Authorization to produce Performed Music, Voice, and Other Sounds For good and valuable consideration, the receipt of which from Palm Beach State College is acknowledged, I hereby grant to said Palm Beach State College and its employees, agents and assigns, the right to use any recordings made by Palm Beach State College of my voice and all instrumental, musical, or other sounds produced or created by me in and in connection with the exhibition, theatrically, on television, or otherwise, or manufacture of videocassettes, of any motion pictures or videotape recordings in which the same may be used or incorporated, and also in the advertising, exploiting and/or publicizing of any such motion pictures, but not limited to television or theatrical pictures. This pertains only to use in conjunction with the film _____________________________ directed by ________________ and if use of music is wanted for any other film, I must be contacted first. I hereby certify and represent that I have read the foregoing and fully understand the meaning and effect thereof and, intending to be legally bound, I have hereunto set my hand this ___ day of _________ 20__. _____________________________ Print Name ________________________ Telephone # _____________________________ Street Address _____________________________ City State Zip _____________________________ Signature ________________________ Witness