Video Release Form
Desert Hearts Productions
111 Park Place
Venice, CA 90291
(310) 399-0013
ddeitchco@earthlink.net
www.desertheartsthemovie.com
I hereby grant Desert Hearts Productions (www.desertheartsthemovie.com) the unrestricted right to use and publish the video content submitted to Desert Hearts Productions (www.desertheartsthemovie.com in any print, electronic, digital or other media; and to alter the same without restriction. I further acknowledge that my participation is voluntary and that I will not receive financial compensation of any type associated with the taking or publication of this content. I have the right to request the removal of my coming out story video from the Desert Hearts website (www.desertheartsthemovie.com) at any time, and the content will be removed within 30 days of receiving the request. As the host of this media on the video sharing website Vimeo (www.vimeo.com) I am responsible for the privacy of this video on Vimeo outside the Desert Hearts Inspired Coming Out Stories channel (https://vimeo.com/channels/1215253) and Desert Hearts Facebook Page. I hereby release Desert Hearts Productions and its legal representatives and assigns from all claims and liabilities relating to said images.
Name
Parent/Guardian Name
Address
Signature of Person over 18 or Parent/Guardian
Date