Actor Release Form

Date: 08th February 2013 Production Company: Sathura Productions Contact Number: 01856798542 Email address: Productions@sathuraproductions.com Website: www.sathuraproductions.com To be completed by the Actor Name: DOB: Address: Number: Email: For good and valuable consideration of ___________________________________ herein acknowledged as received, and by signing this release I hereby give the company and all agents related permission to license the images and for these images to be portrayed in any of SEIZED production, advertising and marketing. I agree that the images may be combined with other images, text and graphics and cropped, altered or modified I agree that I have no rights to the images, and all rights of the images belong to the company named above. I acknowledge and agree that I have no further right to additional consideration or accounting, and that I will make no further claims for any reason to the company. I acknowledge and agree that this release is binding upon my heirs and assigns and I agree that this release is irrevocable. I consent to the inclusion of this Actor release form including the personal details recommended in it being added to the database owned or operated by Sathura Productions.

Witnessed by: _______________________________ Signature: ___________________________________

Actor Signature: ____________________________ Head of Production: ________________________