Music Release Form

1. For good and valuable consideration the receipt and adequacy of which is hereby acknowledged, the undersigned (I, me, my) agree to
furnish the musical compositions, recordings, performances, and/or other materials described below (collectively “Material”) intended to
be incorporated in and used in connection with a motion picture being produced by ___________________________________
(“Producer”) tentatively titled ________________________________________________(“Film”).

The description of the Material is as follows: (please list title of music; if original work, list composer and/or musician; if from music
service or music library, please list the name of the service/library and contact information.)
__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

2. I hereby irrevocably grant to Producer the right to incorporate the Material, and any portions thereof, in whole or in part in the Film in
any manner at Producer’s sole discretion, and to use and exploit the Material (as incorporated in the Film) in all media, versions and
forms, whether now known or hereafter devised, in all languages, throughout the universe, in perpetuity, including, without limitation,
television, the Internet, DVD, books, merchandise and all ancillary exploitation, and in any advertising, publicity or promotion for the Film.
Producer has the right to alter or modify the Material in any manner, at its sole discretion. Producer may in its sole discretion accord me
credit in the Film and/or otherwise for such use.

3. I represent that I have the right to grant to Producer the right to use the Material without the necessity of obtaining the consent of any
third person or entity, and that the Material does not infringe the copyright or violate any right of publicity, privacy or any other right of any
person or entity. Nothing herein requires Producer to use the Material. I agree to indemnify and hold harmless Producer and any person
claiming under Producer, and the officers, directors, shareholders, employees, agents and representatives thereof, from and against any
liabilities, losses, claims, demands, costs (including, without limitation, reasonable attorneys’ fees) and expenses arising in connection
with any breach or alleged breach by me of any above representations or agreements. I hereby agree not to assert any claim of any
nature whatsoever against anyone relating to the exercise of the permissions granted hereunder. I acknowledge that, in the event of any
breach by Producer or any third party, the damage, if any, caused me thereby will not be irreparable or otherwise sufficient to entitle me
to seek injunctive or other equitable relief. I acknowledge that my rights and remedies, if any, in any such event will be strictly limited to
the right, if any, to recover compensatory monetary (but not punitive or consequential) damages in an action at law, and I will have
neither the right to rescind or terminate this Agreement or any of Producer’s or its licensees’ or assigns’ rights hereunder, nor the right to
enjoin the production, exhibition or other exploitation of the Film or any subsidiary or allied rights with respect thereto, nor will I have the
right to terminate my obligations hereunder by reason of such breach.

4. I agree to timely execute and deliver (or to procure the timely execution and delivery to Producer of) any additional documents which
Producer may require to evidence its rights. I hereby appoint Producer, or its nominee, as my irrevocable attorney-in-fact, with the right,
but not the obligation, to prepare or complete any such documents and to execute the same in my name, or to obtain execution thereof
by others.

5. In addition to any of its other rights or remedies, Producer will be entitled to seek injunctive relief in the event of any breach of my
representations, warranties and agreements hereunder. Producer and shall have the right to freely assign and license this agreement
and all or a portion of its rights and remedies hereunder, without my consent. This Agreement will inure to the benefit of and will be
binding upon the parties’ respective affiliates, successors, licensees, assigns, heirs and representatives. This Agreement constitutes the
entire understanding and agreement of the parties hereto with respect to the subject matter hereof and cannot be amended except by a
written instrument signed by the parties hereto.

6. I give Producer the foregoing grant of rights with the full knowledge and understanding that Producer may incur substantial expense in
reliance thereon. Producer may at any time elect not to use the Materials, in which case neither party will have any obligation to the
other hereunder.

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 Music Release Form
Agreed and Accepted:

Name: _________________________________________________________________________

Address: ___________________________________________________________________________________

Signature: ______________________________________________________________________ Date: ________________________

Phone: ________________________ Email: _____________________

If Signatory is under 18:

I represent and warrant that I am the parent or guardian of the minor whose name appears above, that I have read and approve of the
foregoing Release, and consent to its execution by my child/ward. I hereby release the Released Parties as set forth and in accordance
with the foregoing Release from any claims and/or causes of action I may have against them of any nature whatsoever. I hereby fully
and unconditionally guarantee my child's/ward’s releases and waivers as set forth above.

Signature of Parent or Guardian: ____________________________________________________________________

Printed Name: ___________________________________________________________________ Date: _______________________

Address: ___________________________________________________________________________________

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