Appearance Release | Anatomy of a Shoreline | Night Out in the Parks 2027

Before you sign

If you were filmed at 63rd Street Beach for Anatomy of a Shoreline, this is the form that lets us include you in the finished documentary.

It takes about a minute. There is no payment attached to it, and there is no obligation — if you would rather not appear, simply don’t sign, and we will leave you out. If you signed on paper at the beach, you do not need to sign again here.

A copy of what you sign is emailed to you as soon as you submit.

Filming a child?

A parent or legal guardian must sign for anyone under 18. Choose “Parent or guardian, for a child” below.

Your details

Full name *

Email * Your copy is sent here

Phone Optional

Where you were filmed

Date you were filmed

The release

1. Permission to record and use my appearance

I give Ras Tafari Inc. (“Producer”) permission to record and to use and reuse my name, likeness, image, voice, statements and performance (together, my “Appearance”) in and in connection with the documentary film currently titled Anatomy of a Shoreline (the “Production”).

2. Where and for how long

This permission covers all media now known or later developed, worldwide, for as long as copyright in the Production lasts.

3. How it may be used

Producer may use my Appearance in the Production itself and in advertising, publicity, festival submissions, free public screenings, educational use, archival use, excerpts and trailers.

4. Editing

Producer may edit the Production as it sees fit. My Appearance may be shortened, used out of sequence, or not used at all. Producer is under no obligation to use it.

5. No payment

I am giving this permission without payment, and I understand that none is owed to me.

6. Ownership

The Production and all recordings of my Appearance belong to Producer.

7. Release of claims

I release Producer, and anyone acting with Producer’s permission, from any claim arising out of the use of my Appearance as described above, including claims of defamation, invasion of privacy, or right of publicity.

8. My assurances

I am at least 18 years old. I have read this release, I understand it, and I am signing it freely.

9. Governing law

This release is governed by the laws of the State of Illinois.

Type your full name to sign *

Date

For crew — the paper version

Print these for the clipboard at the shoot. Anyone who signs on paper does not sign here as well.

Appearance Release — adult (.docx)
Appearance Release — parent or guardian, for a child (.docx)

Ras Tafari Inc., 1401 E. 71st St., Chicago, IL 60619 · selassiefest@gmail.com · (872) 255-9333. Release version v1-2026-09. Questions about this form, or want a signature withdrawn? Email us and we will take care of it.