Performer Consent And Release Agreement

Uploader’s Full Legal Name (the “Uploader”)

First

Last

Performer’s Full Legal Name (the “Performer”, “I”, “my”)

First

Last

Performer’s Residential Address

Title or Description of the Video/Pictures (the “Content”)

Date of production of the Content (MM/DD/YYYY)

Site on which the Content is to be uploaded to (the “Site”)

PERFORMER SIGNATURE

Performer Signing Date

Email