THE HORROR WE MAKE Model Release

Please complete the following form as agreed upon with Koa Aloha Media.

We will be following appropriate COVID safety guidelines as dictated by the location where we will be shooting, primarily for Orange County, California if you are coming on set to shoot your segment.

The Horror We Make Release Form

Please complete read and complete the information below as completley as possible.

Name of Project *

If the name of project is different than above, please list the project you are involved with.

DIGITAL SIGNATURE *

Please type your full legal name as a digital signature acknowledging that you have read and understood the terms of the above listed release.

Email *

Please Enter your address and we will send you a copy of the release.

IMDB Listing (if available)

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Additional Terms (if any)

Please Enter your Mailing Address Below *

Additional Info

Participation, Release, Limited Liability in The Horror We Make *

I hereby acknowledge that I am participating in a motion picture named [Name in Form Below] being produced by Koa Aloha Media, (hereafter, Producer).

TERMS OF AGREEMENT FOR SHOOT/MODEL RELEASE/LOCATION USE/PROPERTY USE: I hereby irrevocably grant to the Producer, its licensees, agents, successors and assigns, the right, but not the obligation, in perpetuity throughout the world and in all media, now or hereafter known, to use (in any manner it deems appropriate, and without limitation) in and in connection with the motion picture, by whatever means exhibited, advertised or exploited:

1) my appearance in the motion picture, still photographs of me, recordings of my voice taken or made of me by it, any music sung or played by me, and my actual or fictitious name.

I acknowledge that, unless noted and agreed to by both parties and noted in the "applicable terms" below, this agreement is for a payment of $0 for my participation and does not include deferred pay, motion picture ownership through points or percentages or additional monies to be paid through distribution of all known and future media, advertising, merchandising, or promoting.  If additional payments are agreed upon, they shall be agreed upon on a separate contract.

Use of appearance, and/or location, and/or song/music as noted above by the Producer and/or is strictly limited to the film/video referenced herein. Furthermore, I acknowledge that the Producer., or its assigns may shoot behind the scenes “making of ” footage, for use in a motion picture, and I hereby irrevocably grant to the Producer, its licensees, agents, successors and assigns, the right, but not the obligation, in perpetuity throughout the world and in all media, now or hereafter known, to use (in any manner it deems appropriate, and without limitation) in and in connection with the motion picture, by whatever means exhibited, advertised or exploited: my appearance in the motion picture, still photographs of me, recordings of my voice taken or made of me by it, any music sung or played by me, and my actual or fictitious name.

LIMITED LIABILITY: Furthermore, I understand that during my participation in the production, I may be exposed to a variety of hazards and risks, foreseen and unforeseen, that may include, but are not limited to, personal injury, property damage and death. To the fullest extent allowed by law, I agree to waive, discharge claims and release from liability the Producer, its officers, directors, employees, agents and leaders from any and all liability on account of, or in any way resulting from Injuries or Damages. I understand and intend that this assumption of risk and release is binding upon my heirs, executors, administrators and assigns, and includes any minors accompanying me on the Project.

I have read, understood and acknowledge the terms of participation, the model release, and limited liability as noted above.

Yes

Do not continue if you disagree.

I agree to not post or share, on any media, any on-set footage images, set photos, cast photos, behind the scenes images, or still photos of the production of THE HORROR WE MAKE without written consent from Brian Barsuglia.

Yes

Do not continue if you disagree.

If you have any questions, please reach out at bbarsuglia@socalemc.com

Thank you!