Play Pause Unmute Mute Your Story Release Form Please enable JavaScript in your browser to complete this form.Name of Individual Being Recorded *FirstLastEmail *Project NameAdditional notesI hereby grant Your Story, its directors, officers, employees, agents, and designees (collectively “Your Story”) non-revocable permission to capture my image and likeness in videotapes, motion pictures, recordings, or any other media (collectively “Images”). I acknowledge that Your Story will own such Images and further grant its client permission to copyright, display, publish, distribute, use, modify, print and reprint such Images in any manner whatsoever related to its client’s business, including without limitation, publications, advertisements, brochures, web site images, or other electronic displays and transmissions thereof. I further waive any right to inspect or approve the use of the Image by the Your Story and it’s client prior to its use. I forever release and hold Your Story and its client harmless from any and all liability arising out of the use of the Images in any manner or media whatsoever, and waive any and all claims and causes of action relating to use of the Images, including without limitation, claims for invasion of privacy rights or publicity. I hereby warrant that I am eighteen (18) years old or more and competent to contract in my own name or, if I am less than eighteen years old, that my parent or guardian has signed this release form below. This release is binding on me and my heirs, assignees and personal representatives. Electronic signatures are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.Conditions *Choice 1Name of adult being recorded or Guardian if applicable *FirstLastPlease fill out your name here if you are the adult being recored or have your Guardian sign their name if you are under aged.Date / Time *I agree to the conditions above. Electronic signatures are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.Submit