Video Release

Permission and Release Form for Photographic / Video / Audio Production


The undersigned enters into the following agreement (“Agreement”) with 911 Academy Inc. (“Producer”).  I have been informed that Producer is capturing footage and that my name, likeness, image, voice, appearance and/or performance is being recorded and made part of the recording in which I may appear, at any point in time.

  1. I grant Producer and its designees the right to use the Product in any format, now known or later developed. I grant, without limitation, the right to edit, mix or duplicate and use or re-use Product in whole or in parts as Producer may elect. Producer or its designees have complete ownership of the Product, including copyright interests.
  2. I grant Producer and its designees the right to broadcast, exhibit, market, and otherwise distribute the Product, in whole or in parts, and alone or with other products, for any purpose Producer or its designees determine. This grant includes the right to use Product for promoting or publicizing.
  3. I have the right to enter into Agreement and am not restricted by commitments to third parties.
  4. Producer has no financial commitment or obligations to me as a result of Agreement.
  5. It is understood that all of the Materials, and all films, audiotapes, videotapes, reproductions, media, plates, negatives, photocopies, and electronic and digital copies of the Materials, are the sole property of Company. I agree not to contest the rights or authority granted to Company hereunder. I hereby forever release and discharge Company, its employees, licensees, agents, successors, and assigns from any claims, actions, damages, liabilities, costs, or demands whatsoever arising by reason of defamation, invasion of privacy, right of publicity, copyright infringement, or any other personal or property rights from or related to any use of the Materials. I understand that Company is under no obligation to use the Materials.
  6. I will not hold Producer liable for any injury that may occur during production event
  7. I hereby release and discharge 911 Academy Inc. and the Event/Publication sponsors and organizers from any and all liability arising out of my participation in the Event, or in connection with the performance of any of the activities described in this document as permitted herein, including but not limited to my rights of privacy or publicity, copyright, patent, trade secret, moral or trademark rights.

In consideration of all the above, I hereby acknowledge receipt of reasonable and fair consideration from Producer. I have read, understand and agree to all of the above and that the rights granted Producer herein are perpetual and worldwide:


If this person is under age 18 please fill out information below.  



Participant's info or legal guardian must sign below. I certify that I am the legal guardian of the model named above. I give my consent to the foregoing on his or her behalf.

Leave this empty:

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Signed by Chad Talbot
Signed On: November 30, 2020

Signature Certificate
Document name: Video Release
lock iconUnique Document ID: bfcb91a8046f5dacaa3a4c2179431849a5711973
Timestamp Audit
November 30, 2020 1:28 pm PDTVideo Release Uploaded by Chad Talbot - contact@911academy.us IP