ACTOR/EXTRA PAY FORM
In exchange for the payment detailed on this page, I grant this production and associated entities the absolute right to use my image, likeness, and physical representation in perpetuity, be it by my name, a fictitious name, or in character. I waive my right to inspect this representation, as well as my right to be notified of this representation. I agree that I do not have the right to approve or inspect any finished product. I agree to hold harmless the client and any other person using my likeness is accordance with this production. I agree that I may not hold this production liable for misrepresenting or defaming me, and that all alterations to my image are acceptable to me.
Fields: 1 1/2 x, 2 x, Adjusted, Agent Name, AM, Amount, Basic, Call Time, City, Company, Date, Do Not Write In This Section, Employee Information, Employee Name, Extras, First, From, Hair/Makeup, Hours, Known As, Last Name, Meal Breaks, Meal Penalties, Meals, Normal, Notes, Overtime, Pay Rates, Performer Phone #, Performer's Signature, Phone Number, PM, Production #, Props, Rate, Send Check To Agent?, Set Dismissal, Show, Smoke, Social Security #, State, Street Address, To, Total, Total Pay, Travel, Type of Work, Wardrobe, Weather, Work Hours, Zip