Depiction Release - Documentary (Short Form)

for Your State

This short-form Depiction Release allows a filmmaker or producer to record an interview of a subject for inclusion in a motion picture or television documentary. This release set forth the arrangement between the parties and is available for immediate download.

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This Depiction Release Documentary Short Form for Motion Picture and Television Release is between an individual and documentary film maker. This Depiction Release effectively states that an individual has consented to the use of a videotaped or filmed interview and the individualís likeness and voice. This agreement grants rights for worldwide perpetual use in all mediums set out in the agreement. It is vital that this type of agreement be memorialized in writing in the event there are future questions or concerns by the individual or his/her heirs and assigns.

This Depiction Release Documentary Short Form includes the following:
  • Party: Sets forth the name of the party being depicted;
  • Rights of Use: Sets out the rights to use a photo, silhouette or likeness and voice in connection with the documentary;
  • Rights Granted: The rights granted are worldwide and perpetual and include all mediums;
  • Signature: The depicted party must sign and date the release.

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This attorney-prepared packet contains:
  1. General Information
  2. Depiction Release Documentary Short Form
State Law Compliance: This form complies with the laws of all states
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
 
DEPICTION RELEASE
DOCUMENTARY SHORT FORM
 
(Motion Picture and Television Release)
 
I hereby irrevocably agree and consent that you, _________________, and your assigns, may use all or part of your videotaped or filmed interview of me for your documentary program about _________________.
 
You have the right to use my picture, silhouette and other reproductions of my likeness and voice in connection with any motion picture or television program in which this interview may be incorporated, and in any advertising material promoting it.
 
You may edit my appearance as you see fit.
 
You shall have all right, title and interest in any and all results and proceeds from said use or appearance.
 
The rights granted you are worldwide, perpetual and include the use of this interview in any and all mediums (all or part of the program may be shown), including but not limited to theatrical, all forms of television and all forms home video, whether now known or hereafter invented.
 
This consent is given as an inducement for you to interview me and I understand you will incur substantial expense in reliance thereof.
 
You are not obliged to make any use of this interview or exercise any of the rights granted you by this release.
 
I have read and understand the meaning of this release.
 
 
 
         
Signature      Date
 
 
         
Print Name       Phone
 
Number of Pages2
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#28003
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