Dr. Alfred C. Giovetti, CPA, Writer, Editor, TV Host, Producer, and Lecturer, The Computer Show, 1615 Frederick Road, Catonsville, MD 21228-5022, phone: 410-747-0396, fax: 410-747-6357, beeper: 410-536-2228, AlGiovetti@cis.compuserve.com, AlGiovetti@AOL.com, A.Giovetti@GEnie, algiovetti@msn.com and wizards@charm.net
fax to:410-747-6357
Alfred Giovetti Productions and The Computer Show
Release Form
Date: ______________________________
IN consideration of my willingness to appear in a production on video. I hereby release you, your agents, successors, licensees and assigns, and each of them, from and against any and all claims, liabilities, demands, actions, causes of action, costs and expenses whatsoever, at law or in equity, known or unknown, anticipated or unanticipated, suspected or unsuspected, arising out of my performances, your photographing or recording me or my voice, the broadcast or promotion of the use of such photographs or recordings in connection with this recording or subsequent use in any form, at any time and in any medium presently known or unknown. I grant you the perpetual right to photograph me and make recordings of my voice and further acknowledge that you may delete or edit, change or rearrange all or any of the results of my services.
I represent that I am eighteen (18) years of age. I affirm that neither I, nor anyone acting for me, gave or agreed to give anything of value to any member of the production staff for arranging my appearance.
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Signature
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Name (Print) ....................................................................... email
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Company Name ............................................................... website
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Street, Address, City, State, Mail Code, Country
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Topic of Interview and Products Covered
