Actor Media Release Form

AUTHORIZATION FOR PHOTOGRAPHS/VIDEO

I hereby grant permission to Visions Performing Arts Center (VPAC) to obtain video images and /or photographs of myself for use by VPAC, now or in the future, in brochures, and any publicity, in any medium, which will be viewed by:

1. Public audiences reached by newspapers, magazines, television and any other media.
2. General audiences to who the mission and vision of VPAC is of interest.In addition, I understand and agree that I will not be entitled to any compensation from VPAC or its sponsors or anyone associated with the organization now or at any time in the future with respect to the use of the videotapes and/or photographs, nor will there be any approval or inspection of the images or their use.

I understand and acknowledge that my

Name *

may be used by the news media.

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