Internet Talent Release Form

Talent Name: ____________________ Project Title: ____________________________

I hereby consent for value received and without further consideration or compensation to the use (full or in part) of all videotapes taken of me and/or recordings made of my voice and/or written extraction, in whole or in part, of such recordings or musical performance

at __________________________ on ________________________ 20_______

        (Recording Location)                             (Month) (Day) (Year)

by ______________________________ for ______________________________

        (Producer)                                       (Producing Organization)

for use at the CyberCollege and the InternetCampus web sites.

Talent's signature__________________________________________________

Address ________________________________ City _____________________

State ____________________ Zip code _____________

Date: ____/____/____

__________________________

If the subject is a minor under the laws of the state where modeling, acting, or performing is done:

Legal guardian _________________________ ___________________________

                                 (sign/print name)

Address _____________________________ City ________________________

State ______________________ Zip Code ___________

Date: ____/____/____

NOTE: This is for illustration purposes only.



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