Extra Release
(Independent Extra)

Extra Name: ____________________________________________
(Print Names)

Producer(s) Name: _______________________________________________

Producer Company: ______________________________________________

Project Name: __________________________________________________

Project Genre: _________________________________________________
(film, music video, stage production, game show, etc)

Herein this Agreement the independent Filmmaker is called the “Producer”.

1. The Extra hereby confirm that she/he is over the age of eighteen and the Extra agrees to be photographed in connection with the above named Project.

2. The Extra hereby grants to the Producer, the Producer’s successors, assigns and licensees, the right to use at the Producer’s desire, all video, still and motion pictures which are made of the Extra in connection with the above mentioned Project.

3. The Extra is giving her/his Acting skills and services gratis to the Project. The Extra further understands that by granting this permission the Extra is irrevocably giving up all rights and claims to monetary compensation for any future uses of this material by the above persons & organizations.

4. This Agreement shall not at any time render the Extra an employee, nor partner, nor agent of the Producer for any purpose whatsoever. The Extra is and will remain an “Independent Extra” in her/his relations to the Producer. The Producer shall not be responsible for withholding any Government remittances with respect to the Extra’s compensation hereunder. The Extra shall have no claim against the Producer hereunder or otherwise for vacation pay, sick leave, retirement benefits, social security, worker’s compensation, health or disability benefits, unemployment insurance benefits, or employee benefits of any kind.

5. The Extra agrees to hold The Producer, Cast and Crew and any and all Third Parties harmless against any liability, loss or damage (including reasonable attorney’s fees) caused by or arising from . . . (continued)