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Back To Georgia

Music Video Contant Agreement

By agreeing to and submitting this form, you give and forever grant the owner of this work (Roberta Lea Halmond-Walters) and partners the agency to publish, promote, advertise, and copyright your picture, portrait and likeness, in whole or in part, including alterations, modifications, derivations and composites thereof, in publishing, advertising and promotion of Back To Georgia Music Video. 

You recognize your performance or appearance in the Content and irrevocably release Roberta Lea and partners/affiliates/licensors/licensees of any and all liability or claims arising out of or in any way resulting from the use of your image. 

Parent or Guardian of Minor

I, [Parent or Guardian], here by warrant that I am the (Parent or Guardian) of the child, a minor, and have full authority to authorize the above Release which I have read and approved. I hereby release and agree to indemnify the licensed parties and their respective successors and assigns, from and again any and all liability arising out of the exercise of the rights granted by the above Talent Release. 


Photography consent & release form

Thanks for submitting!

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