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I hereby authorize Producer to record and edit into the Young Black Male 2 and related materials my name, likeness, image, voice and participation in and performance on film, tape or otherwise for use in the above Young Black Male 2 or parts thereof (the “Recordings”). I agree that Young Black Male 2 will own such Images and further grant the Young Black Male 2 permission to copyright, display, publish, distribute, use, modify, print and reprint such Images in any manner whatsoever related to Young Black Male 2 business, including without limitation, publications, advertisements, brochures, web site images, or other electronic displays and transmissions in perpetuity, throughout the world.

Producer may use and authorize others to use all or parts of the Recordings. Producer, its successors and assigns shall own all right, title and interest, including copyright, in and to the Young Black Male 2, including the Recordings, to be used and disposed of without limitation as Producer shall in its sole discretion determine.

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If you are under the age of 18 years old you must have a parent or guardian signature.

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