Music Release Form

A separate copy of this form is to be completed by each musician/singer.

I hereby acknowledge my participation in the submitted video

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Title of Program

I hereby authorize you to use my music as heard within the program and grant all rights to said production owner to use such recordings, in whole or in part for submission to the 'Circles of Light' compilation video as distributed by Home of Poi Ltd.

You may also use my name, and/or biography for publicity and promotion as deemed necessary.

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Produced by

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Signature of musician/singer

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(Please print music performer's full name here)

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Your name and music title to appear in the credits

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Address


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City, State, Country, Zip

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Telephone

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Fax

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Email

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Website

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Date

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