Media Release | Brooks Avenue

Brooks Avenue LLC
& Associates
Multi-Media Release Form
Please Fill Out All Information Pertaining to You

TALENT

Talent's Real Name

Talent's Stage Name

Talent's Date of Birth

Talent's Cell

Talent's Email - No School or Work

Talent's Address

Submit Headshot, Full Body & Choice Photos Below

SECONDARY CONTACT

Guardian or Secondary Contact

Secondary Cell

Secondary Email

Secondary Address

FAMILY / GROUP TALENT
Talent Contact = Parent-Manager
Secondary Contact = Parent-Leader
Children or Members Below

1 Talent's Name

Talent's Date of Birth

2 Talent's Name

Talent's Date of Birth

3 Talent's Name

Talent's Date of Birth

4 Talent's Name

Talent's Date of Birth

5 Talent's Name

Talent's Date of Birth

6 Talent's Name

Talent's Date of Birth

7 Talent's Name

Talent's Date of Birth

8 Talent's Name

9 Talent's Name

Talent's Date of Birth

10 Talent's Name

Talent's Date of Birth

LOCATIONS
Talent Contact = Main Contact
Secondary Contact

ABOUT YOUR LOCATION

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

MARKETING MEDIA

Marketing Photo

Upload File

Marketing Photo

Upload File

Marketing Photo

Upload File

Additioal Photos

Additional Photos

Enter URL

I hereby give permission to Brooks Avenue, LLC, Equal Equity Productions, Sharpened Iron Studios, Diane Dick Model & Talent Agency, Main Street America and All Affiliated Businesses To use my place of business, name, image, voice, social media posts, YouTube Reels, marketing materials recorded by us or another company. To be used for promotional purposes, presentations and/or publications. I waive any rights of compensation or ownership thereto.

Name of Responsible Person

Signature of Responsible Person

Thank You for submitting!

New Shoot Amendment

Brooks Avenue LLC & Associates Multi-Media Release Form Please Fill Out All Information Pertaining to You

TALENT

Submit Headshot, Full Body & Choice Photos Below

SECONDARY CONTACT

FAMILY / GROUP TALENT Talent Contact = Parent-Manager Secondary Contact = Parent-Leader Children or Members Below

LOCATIONS Talent Contact = Main Contact Secondary Contact

MARKETING MEDIA

Brooks Avenue LLC
& Associates
Multi-Media Release Form
Please Fill Out All Information Pertaining to You

FAMILY / GROUP TALENT
Talent Contact = Parent-Manager
Secondary Contact = Parent-Leader
Children or Members Below

LOCATIONS
Talent Contact = Main Contact
Secondary Contact