OCCIDENTAL COLLEGE
1600 Campus Road, Los Angeles, CA 90041-3314
ACTOR RELEASE FORM
PRODUCTION TITLE: __________________________________________________________________
(Production)
ACTOR NAME: ________________________________________________________________________
In consideration of my participation in the Occidental College Production named above, I, the undersigned,
do hereby expressly and irrevocably authorize Occidental College, its officers, trustees, agents,
representatives, employees, students and volunteers (the College), to take photographs and video
(Photographs) of me, and interview, publish, print and broadcast my voice and Photographs through the use
of brochures, publications, posters, printed materials, displays, signs, TV/video/audio broadcast and
internet/web or other electronic means. The term “Photograph” as used in this authorization is intended to
have the broadest definition possible and includes motion picture (with or without sound) or still
photography in any format (including electronic), as well as videotape, videodisc, web and any other means
of recording and reproducing visual images and sound.
I agree that the Occidental College student director of this Production shall own any and all rights in the
Photographs, and I waive any and all uses of my name, likeness, voice, or character including but not
limited to, the right to reproduce, distribute, sell, transmit, publish, exhibit, or otherwise use the
Photographs, Production or any portion thereof. I understand that in proceeding with the Photographs and
Production, the College (including the Occidental College student director) is doing so in full reliance on
the foregoing permission.
I release whatever rights, title, or property interest I may have in the Production. I understand that I shall
receive no compensation for my appearance and participation in the Production or the Photographs.
Further, I hereby unconditionally release Occidental College, its officers, trustees, agents, representatives,
employees, students and volunteers (the Released Parties) from any and all liability that may or could arise
from the taking, recording, exhibition, telecast, publication, distribution or other use of the Photographs and
the Production. I agree to indemnify and hold harmless the Released Parties from and against any claim for
monetary compensation or damages (including reasonable attorneys’ fees) resulting from, related to, arising
out of, or concerning, the Production or the Photographs.
By signing below, I (Actor) ______________________________________________ understand that I am
participating/performing in a NON-UNION, NON-SAG STUDENT PRODUCTION.
Signature: __________________________________________
Date: ______________________
Home Address: _____________________________________
__________________________________________________
Telephone Number: _________________________________
IF ACTOR IS UNDER THE AGE OF 18, PARENT/GUARDIAN SIGNATURE IS ALSO
REQUIRED BELOW.
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OCCIDENTAL COLLEGE
1600 Campus Road, Los Angeles, CA 90041-3314
ACTOR RELEASE FORM
PRODUCTION TITLE: __________________________________________________________________
ACTOR NAME: ________________________________________________________________________
By signing below, I represent that I am at least 18 years of age and am the parent or guardian of the Actor
identified above. I have read the foregoing agreement and am familiar with all of the terms and conditions
thereof and I consent to its execution by the Actor. I further state that I am fully competent to sign this
Agreement; and that I execute this release for full, adequate, and complete consideration fully
intending for myself, for the Actor, and for Actor’s family, estate, heirs, administrators, executors,
personal representatives, and legal predecessor, successors, and assigns to be bound by the same.
I also represent that, in compliance with section 11757 of Article 1 of Subchapter 2 of Chapter 6 of the
Division of Labor Standards Enforcement (https://www.dir.ca.gov/t8/11757.html), I shall be present with
and accompany, and shall be within sight or sound of, Actor, at all relevant times.
Parent/Guardian
Signature: ______________________________________
Parent/Guardian Printed Name and Relationship to Minor:
______________________________________________
______________________________________________
Home Address: ________________________________
_____________________________________________
Telephone Number: ____________________________
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Date: _________________________