STANDARD/MINOR RELEASE
	PARTICIPANT’S NAME:	 		
	PROGRAM:	
In consideration of the sum of One Dollar, ($1.00), receipt for which is hereby acknowledged, and for the opportunity to participate in the above-identified video program produced by [YOUR COMPANY NAME], I agree that the program(s) may be broadcast and distributed without limitation through any means and I shall not receive any compensation for my participation.
	I confirm that any and all material furnished by me for this program is either my own or otherwise authorized for such use without obligation to me or any third party.  I also agree to the use of my name, likeness, portrait or pictures, voice and biographical material about me for educational, program or series publicity and organizational promotional purposes.
	I further agree that my participation in the program confers upon me no rights to use, ownership or copyright.  I release [YOUR COMPANY NAME], its employees, agents, and assigns from all liability which may arise from any and/or all claims by me or any third party in connection with my participation in the program(s).
	It is understood that [YOUR COMPANY NAME] is under no obligation to broadcast the above-identified program(s) or series.

Agreed to and signed this 	 day of 				, 2000 by:

													
Participant’s Signature		Street Address		City, State, Zip

I, 						 am the parent or legal guardian of the above-named minor and I endorse the above statement in his/her behalf on this 	 day of 						, 2006.

					/				/				
Parent or Guardian		      Street Address	              City, State, Zip