Extras Release Form – “Life’s a Drag”

I am a non-union actor, agreeing to appear in Life’s a Drag, produced by Silver State Storytellers.

I am not receiving any compensation for my participation in this project.

I hereby grant Silver State Storytellers the right to record and use my image, voice, likeness, performance, etc. for the purposes of this production.

I further grant Silver State Storytellers the right to use and/or distribute any material filmed, taped, or recorded of me in the production, as well as any promotions or advertising related to the production.

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Name *

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Are there children in your party? *YesNo

Please list the names fo the children in your party *

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• I hereby allow the reproduction and publication of my child’s image for the purpose of this film and any marketing associated with it.

• Please check if you would like to opt out of recieving information from Silver State Storytellers.

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By clicking the “Submit” button, I confirm that I have read and understood the terms stated above and hereby give my consent and agreement to abide by them.