TALENT RELEASE Moll Dyer Film For good and valuable consideration, the receipt of which is hereby acknowledged, I, ,(“Talent”), hereby grant Thurston Production, LLC (“Producer”) permission to use my likeness, voice, and performance in all media (the "Recordings"). I understand and agree that any Recordings using my likeness will become the property of Thurston Production, LLC and will not be returned.In consideration of $ , paid by Thurston Production, LLC, I hereby authorize Producer to edit, alter, copy, exhibit, publish, or distribute any Recordings for purposes of publicizing and producing the film Moll Dyer or for any other related lawful purpose, for an indefinite period of time. In addition, I waive any right to royalties or other compensation arising out of, or related to, the use of the Recordings.I hereby hold harmless and release and forever discharge Thurston Production, LLC from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.I am at least 18 years of age and am competent to contract in my own name. I have read this release before signing below and I fully understand the contents, meaning, and impact of this release.Signature Contact Info Producer (for Thurston Production, LLC): SignatureSignature First Name Last Name p> First Name Last Name p> Street Address Address Line 2 City State Zip p> Area Code Phone Number p>Email DateDate Print FormSubmit Clear Form Should be Empty: