Friday, August 30, 2013

CALLTIMES FOR SAT AUG 31: SEE BELOW. READ CAREFULLY! LOTS O' DIFFERENT CALLS.

Breakfast will be ready at 1:30pm. I encourage you to bring some snacks...crafty is lacking on this show.

*Trevor Bush is need of a ride to set tomorrow. His number is 575-740-0176

5:00pm
Townspeople 
David Innes
Peggy Innes
Tom Gleason
Nathan Gleason
Charles Henderson
4:30PM
Doctor
Cody Feador
4:30PM
Virgil's wife FE
Christine Schwatken
3:00PM
Desperadoes (2)
Owen Densford
Wynston Vose

3:00PM
Jim Taylor FE
Cameron Earl
3:00PM FE
Joe Hardin
TJ Bowlin
6:00PM
Sheriff White FE
Daniel Garcia
6:00PM
Drunken Cowboys 
Philip Heisey
Lance Townsend
Joe LaGrange
9:00PM
Frank Stillwell FE
Brad Royster
2:00PM
Frank McLaury FE
JD Marmion
2ND UNIT
2:00PM
African-American Deputy FE
Charles Hill III
2:30PM
Bank Patrons 
Melody Carpenter
Scott Esquibel
2:30PM
Masked Robbers
Jeremie Dalaba
Warren Christopher
3:00PM
Misc Saloon 
LC Read
Trevor Bush
Santo Militello



PLEASE READ THIS LIABILITY WAIVER CAREFULLY: 
PAID APPEARANCE RELEASE
For good and valuable consideration, receipt of which is hereby acknowledged, I authorize CASTLE
PICTURES, INC. (“Producer”) and Discovery Communications, LLC (“Company”) and their
respective parents, affiliates, subsidiaries, licensees, successors and assigns to make use of my
appearance for the program tentatively entitled: Gunslingers: Icons of the Old West” (“Program”)
and in connection with Producer and/or Company or otherwise.

I agree that you may tape and photograph me, and record my voice, conversation and sounds,
including any performance of any musical composition(s), during and in connection with my
appearance and that you shall be the exclusive owner of the results and proceeds of such taping,
photography and recording with the right, throughout the world, an unlimited number of times in
perpetuity, to copyright, to use and to license others to use, in any manner, all or any portion thereof or of a reproduction thereof in connection with the Program or otherwise. For purposes of clarity, I expressly waive any and all moral rights I may have in connection with my appearance.
I further agree that you may use and license others to use my name, voice, likeness and any
biographical material concerning me which I may provide, in any and all media and in the promotion, advertising, sale, publicizing and exploitation of the Program and/or otherwise and ancillary products (e.g., merchandise) in connection with the Program and in connection with Producer and/or Company or Company’s affiliated services, throughout the world in all media, an unlimited number of times in perpetuity. I further represent that any statements made by me during my appearance are true, to the best of my knowledge, and that neither they nor my appearance will violate or infringe upon the rights of any third party.

I hereby waive any right of inspection or approval of my appearance or the uses to which such
appearance may be put. I acknowledge that you will rely on this permission potentially, at substantial cost to you and hereby agree not to assert any claim of any nature whatsoever against anyone relating to the exercise of the permissions granted hereunder.
All provisions hereof concerning my participation and the Program shall be kept strictly confidential by me and my representatives. Neither I nor my representatives shall issue any press releases or public statements about Producer, Company, the Program or my participation hereunder, without Company’s prior written permission.

I acknowledge that during production of the program, I will be working in the proximity of horses, and possibly other animals, as well as in the proximity of stunt activities, including but not limited to the use of firearms shooting blanks. I acknowledge that such proximity may involve risks, including but not limited to bodily injury. I assume full responsibility for all risks that may arise out of or result from my participation in the Program. I agree to conduct myself in a manner that will minimize risk to myself and others. I hereby release, waive, discharge, and hold harmless CPI and any party to which CPI grants any rights in connection with the proceeds and/or Program and all of their parents, affiliates, subsidiaries, licensees, successors and assigns (collectively, “Released Parties”) from any and all claims, suits, liabilities, judgments, costs and expenses (“Claims”) for any personal injury or other loss arising from or relating to my services in the Program. I also agree to defend, indemnify and hold harmless the Released Parties from and against any Claims arising from or related to my own acts or omissions in connection with my services in the Program.

For the right to use my appearance in the Program, Producer shall pay a fee of
$ Dollars. I understand that I am responsible for paying all applicable taxes that may
be imposed thereon, and I release and indemnify Producer and Company from any liability therefor. I further understand that I must properly complete and submit to Producer an IRS Form W-9.]

Thursday, August 29, 2013

CALLTIMES FOR FRIDAY AUG 30: SEE BELOW FOR YOUR CALLTIME, READ MUY CAREFULLY!

**LUNCH will be ready at 12:30pm.

For people just joining this adventure, I want to give you a head's up that this is a low-budget show and the craft services are, well, low budget. I encourage you to bring snacks. There will be water and hopefully a bag or two of chips, but not much else.

1:00PM
Townspeople (10)
Tom Gleason
Nathan Gleason
Charles Henderson
David Innes
Peggy Innes
Jeremie Dalaba
Melody Carpenter
Rachel Otero
Stewart Allen
Santo Militello
Giuseppe Quinn

1:00PM
Joe Clements FE
Brad Royster
1:00PM
Jim Taylor (lynch victim)
Marvin Rath

2:00PM
Jessie Hazell FE
Kathleen Lujan
4:00PM
Mike Williams FE
Isaiah Campbell
4:00PM
Bill Mulvey FE
Scott Flick
2nd Unit Background
2:30PM
Deputy w plate FE
Jeff Franks
4:00PM
Elderly Deputy
Warren Christopher
4:00PM
Friendly guard
Michael Guajardo
4:00PM
Escort guard
Denny O'Connor
6:00PM
Joe Hardin FE
TJ Bowlin
1:00PM
Deputy
Keith Couture
1:00PM
Judges FE
Rich Hassman
Thom Ross
1:00PM
Lawyer
Mike Zullo
2:00PM
Addie Borland FE
Wendy Dial
2:00PM
Fin Clanton FE
Cameron Earl


Wednesday, August 28, 2013

CALLTIMES FOR THURS AUG 29: SEE BELOW. PLEASE PAY SUPER DUPER CLOSE ATTENTION! LOTS OF DIFFERENT CALLS DOWN THERE.

If you have western boots or a felt hat please bring it. 

Breakfast will be ready at 9am.

9:30AM
Townspeople 
Peggy Innes
Melody Carpenter
Stewart Allen
Jeremie Dalaba
David Innes
Warren Christopher
Charles Henderson
Rachel Otero
Guiseppe Quinn
David Pino
9:30AM
Armed Deputy
Dominic Otero
9:30AM
Cowboy Shield
Marcos Roybal
10:00AM
Mattie (Wyatt's wife) FE
Brytnee Ratledge
10:00AM
Morgan Earp's wife
Lisa Hankins
10:00AM
James Earp FE
Gabe Juric
11:00AM
Cowboy thug
Santo Militello
10:00AM
Sheriff White
Dan Garcia
11:00AM
Calamity Jane
Rachel Ross
11:00AM
Prostitutes
Melarie Roller
Stephanie Clock
4:30pm
Snoring cowboy
LC Read
4:30pm
Sweaty transcribing man
Denny O'Connor
10:00AM
Wagon driver
Raliegh's person

Tuesday, August 27, 2013

CALLTIMES FOR WED AUG 28: PLEASE SEE BELOW: Breakfast ready at 7:30am

** If you have cowboy boots or hat please bring them!

8:00AM
Townspeople 
Guiseppe Quinn
David Innes
Peggy Innes
David Pino
Melody Carpenter
Carol Williamson
Melarie Roller
Nathan Gleason
Tom Gleason
Stewart Allen

8:00AM
Informed Citizen FE
Cameron Earl
8:00AM
Alarmed Woman FE
Sandra Reamer

9:00AM
Billy Claiborne FE
Joe Case

9:00AM
Tom McLaury
Andrew Monie



 PLEASE READ THIS LIABILITY WAIVER CAREFULLY: 

PAID APPEARANCE RELEASE

For good and valuable consideration, receipt of which is hereby acknowledged, I authorize CASTLE

PICTURES, INC. (“Producer”) and Discovery Communications, LLC (“Company”) and their

respective parents, affiliates, subsidiaries, licensees, successors and assigns to make use of my
appearance for the program tentatively entitled: Gunslingers: Icons of the Old West” (“Program”)
and in connection with Producer and/or Company or otherwise.

I agree that you may tape and photograph me, and record my voice, conversation and sounds,
including any performance of any musical composition(s), during and in connection with my
appearance and that you shall be the exclusive owner of the results and proceeds of such taping,
photography and recording with the right, throughout the world, an unlimited number of times in
perpetuity, to copyright, to use and to license others to use, in any manner, all or any portion thereof or of a reproduction thereof in connection with the Program or otherwise. For purposes of clarity, I expressly waive any and all moral rights I may have in connection with my appearance.
I further agree that you may use and license others to use my name, voice, likeness and any
biographical material concerning me which I may provide, in any and all media and in the promotion, advertising, sale, publicizing and exploitation of the Program and/or otherwise and ancillary products (e.g., merchandise) in connection with the Program and in connection with Producer and/or Company or Company’s affiliated services, throughout the world in all media, an unlimited number of times in perpetuity. I further represent that any statements made by me during my appearance are true, to the best of my knowledge, and that neither they nor my appearance will violate or infringe upon the rights of any third party.

I hereby waive any right of inspection or approval of my appearance or the uses to which such
appearance may be put. I acknowledge that you will rely on this permission potentially, at substantial cost to you and hereby agree not to assert any claim of any nature whatsoever against anyone relating to the exercise of the permissions granted hereunder.
All provisions hereof concerning my participation and the Program shall be kept strictly confidential by me and my representatives. Neither I nor my representatives shall issue any press releases or public statements about Producer, Company, the Program or my participation hereunder, without Company’s prior written permission.

I acknowledge that during production of the program, I will be working in the proximity of horses, and possibly other animals, as well as in the proximity of stunt activities, including but not limited to the use of firearms shooting blanks. I acknowledge that such proximity may involve risks, including but not limited to bodily injury. I assume full responsibility for all risks that may arise out of or result from my participation in the Program. I agree to conduct myself in a manner that will minimize risk to myself and others. I hereby release, waive, discharge, and hold harmless CPI and any party to which CPI grants any rights in connection with the proceeds and/or Program and all of their parents, affiliates, subsidiaries, licensees, successors and assigns (collectively, “Released Parties”) from any and all claims, suits, liabilities, judgments, costs and expenses (“Claims”) for any personal injury or other loss arising from or relating to my services in the Program. I also agree to defend, indemnify and hold harmless the Released Parties from and against any Claims arising from or related to my own acts or omissions in connection with my services in the Program.

For the right to use my appearance in the Program, Producer shall pay a fee of
$ Dollars. I understand that I am responsible for paying all applicable taxes that may
be imposed thereon, and I release and indemnify Producer and Company from any liability therefor. I further understand that I must properly complete and submit to Producer an IRS Form W-9.]

Sunday, August 25, 2013

CALLTIMES FOR TUES AUG 27: Scroll down for your time. Breakfast will be served at 8:ooam, Check your email for a map.

If you have boots or a cowboy hat can you bring them?





****JJ Jones would like to ride up with someone on Tues if you're coming up fr ABQ, his number is 505-903-2576


8:00AM
Ranch Hands
Wyatt Harper
Devlin Lara
10:00AM
Ranchers (2)

Skip Long
Joseph Thompson

10:00AM
Ann Bassett FE
Laramie Cooley
10:00AM
Isom Dart FE
JJ Jones

10:00AM
Ora Haley FE
Bob Knowlton

8:30AM
Calamity Jane FE
Rachel Ross
8:30AM
Billy's Stepbrother FE
Ethan Dennis
8:30AM
Billy's Stepfather 
Luke Fitch
8:30AM
Catherine McCarty
Rachel Hartzog
8:30AM
Young Billy

Lucien Dale

Friday, August 23, 2013

Calltime for Sat Aug 24: 2:30PM: breakfast ready at 2:00pm. Please read the liability waiver below. The production is requiring that everyone sign one.





PAID APPEARANCE RELEASE
For good and valuable consideration, receipt of which is hereby acknowledged, I authorize CASTLE PICTURES, INC. (“Producer”) and Discovery Communications, LLC (“Company”) and their
respective parents, affiliates, subsidiaries, licensees, successors and assigns to make use of my
appearance for the program tentatively entitled: Gunslingers: Icons of the Old West” (“Program”) and in connection with Producer and/or Company or otherwise.
I agree that you may tape and photograph me, and record my voice, conversation and sounds, including any performance of any musical composition(s), during and in connection with my
appearance and that you shall be the exclusive owner of the results and proceeds of such taping,
photography and recording with the right, throughout the world, an unlimited number of times in
perpetuity, to copyright, to use and to license others to use, in any manner, all or any portion thereof or
of a reproduction thereof in connection with the Program or otherwise. For purposes of clarity, I
expressly waive any and all moral rights I may have in connection with my appearance.
I further agree that you may use and license others to use my name, voice, likeness and any
biographical material concerning me which I may provide, in any and all media and in the promotion, advertising, sale, publicizing and exploitation of the Program and/or otherwise and ancillary products (e.g., merchandise) in connection with the Program and in connection with Producer and/or Company
or Company’s affiliated services, throughout the world in all media, an unlimited number of times in
perpetuity. I further represent that any statements made by me during my appearance are true, to the best of my knowledge, and that neither they nor my appearance will violate or infringe upon the rights of any third party. I hereby waive any right of inspection or approval of my appearance or the uses to which such appearance may be put. I acknowledge that you will rely on this permission potentially, at substantial cost to you and hereby agree not to assert any claim of any nature whatsoever against anyone relating to the exercise of the permissions granted hereunder.
All provisions hereof concerning my participation and the Program shall be kept strictly confidential by me and my representatives. Neither I nor my representatives shall issue any press releases or public statements about Producer, Company, the Program or my participation hereunder, without Company’s prior written permission. 
I acknowledge that during production of the program, I will be working in the proximity of horses, and possibly other animals, as well as in the proximity of stunt activities, including but not limited to the use of firearms shooting blanks. I acknowledge that such proximity may involve risks, including but not limited to bodily injury. I assume full responsibility for all risks that may arise out of or result from my participation in the Program. I agree to conduct myself in a manner that will minimize risk to myself and others. I hereby release, waive, discharge, and hold harmless CPI and any party to which CPI grants any rights in connection with the proceeds and/or Program and all of their parents, affiliates, subsidiaries, licensees, successors and assigns (collectively, “Released Parties”) from any and all claims, suits, liabilities, judgments, costs and expenses (“Claims”) for any personal injury or other loss arising from or relating to my services in the Program. I also agree to defend, indemnify and hold harmless the Released Parties from and against any Claims arising from or related to my own acts or omissions in connection with my services in the Program. For the right to use my appearance in the Program, Producer shall pay a fee of $ Dollars. I understand that I am responsible for paying all applicable taxes that may
be imposed thereon, and I release and indemnify Producer and Company from any liability therefor. I further understand that I must properly complete and submit to Producer an IRS Form W-9.]


**If you have a period looking felt hat please bring it!

2:30PM
US Soldier (10)
Chris Cade
Nicholas Hoyt
Jacob Honeycutt
Michael Eros
Charlie Wormhoudt
Miguel Arambula
Damon Somers
Chris Eros
Cory Broussard

2:30PM
McSween FE
Will Bolt

2:30PM
McSween's Wife
Sandy  Baca

2:30PM
McSween's Kids (2)
Maximus Passeno
Bailey Passeno
2:30PM
Regulators (2)
Shawn
Dustin
2:30PM
Charlie Bowdrie FE
JD Marmion









 

Thursday, August 22, 2013

CALLTIME FOR FRIDAY AUG 22: PLEASE SEE BELOW, BREAKFAST READY AT 1:00PM


1:30PM
Banker FE
Stewart Herd
1:30PM
Clell Miller FE
Brad Royster
1:30PM
Cole Younger FE
Mason Georges
1:30PM
McSween FE
Cory Broussard
3:30PM
Archie Samuels FE
Sky Bleeker 
3:30PM
Ruben Samuels FE
Kevin Wester
1:30PM
Isom Dart
JJ Jones
1:30PM
Ranch Hands
Josh
TJ
6:00PM
Pinkerton Agents
Clay Szenasi
Larry Langway
Jeremie Dalaba
Robert Jensen

Wednesday, August 21, 2013

CALLTIME FOR THUR AUG 22: PLEASE SEE BELOW: BREAKFAST READY AT 8AM

8:30AM
Executioner
Martin Palmer
8:30AM
Jail guard (2)
Mitch Barnes
Damon Somers

US Cavalry Troops (2)
Mason Georges
Wyatt Harper
8:30AM
Reporters (4)
Isaac Luna
Benjamin Krcal
John Spacer
10:30AM
Isom Dart
Danny Theragood





Tuesday, August 20, 2013

CALLTIMES FOR WED AUG 21, PLEASE SCROLL DOWN AND READ.


8:00AM
Garrett's Mounted Posse 
Jon Gonzalez
Wes Trudell
Devlin Lara
8:00AM
Regulator
Scott Esquibel
12:00PM
Joe Hardin FE (10yo)
Cruz Castillo
9:00AM
Charlie Ford
Charlie Wormhoudt
9:00AM
Bill Chadwell FE
Ronald J. Clock
9:00AM
Charlie Bowdrell FE
JD Marmion
9:00AM
Charlie Pitts FE
Mitchell McCarroll
9:00AM
Clell Miller FE
Brad Royster
9:00AM
Cole Younger FE
Mason Georges
4:00PM
Tom Horn's Mother
Thayer Hutchinson
7:00PM
New James Gang
Robert Baldwin


 PLEASE READ THIS LIABILITY WAIVER CAREFULLY: 
PAID APPEARANCE RELEASE
For good and valuable consideration, receipt of which is hereby acknowledged, I authorize CASTLE
PICTURES, INC. (“Producer”) and Discovery Communications, LLC (“Company”) and their
respective parents, affiliates, subsidiaries, licensees, successors and assigns to make use of my
appearance for the program tentatively entitled: Gunslingers: Icons of the Old West” (“Program”)
and in connection with Producer and/or Company or otherwise.

I agree that you may tape and photograph me, and record my voice, conversation and sounds,
including any performance of any musical composition(s), during and in connection with my
appearance and that you shall be the exclusive owner of the results and proceeds of such taping,
photography and recording with the right, throughout the world, an unlimited number of times in
perpetuity, to copyright, to use and to license others to use, in any manner, all or any portion thereof or of a reproduction thereof in connection with the Program or otherwise. For purposes of clarity, I expressly waive any and all moral rights I may have in connection with my appearance.
I further agree that you may use and license others to use my name, voice, likeness and any
biographical material concerning me which I may provide, in any and all media and in the promotion, advertising, sale, publicizing and exploitation of the Program and/or otherwise and ancillary products (e.g., merchandise) in connection with the Program and in connection with Producer and/or Company or Company’s affiliated services, throughout the world in all media, an unlimited number of times in perpetuity. I further represent that any statements made by me during my appearance are true, to the best of my knowledge, and that neither they nor my appearance will violate or infringe upon the rights of any third party.

I hereby waive any right of inspection or approval of my appearance or the uses to which such
appearance may be put. I acknowledge that you will rely on this permission potentially, at substantial cost to you and hereby agree not to assert any claim of any nature whatsoever against anyone relating to the exercise of the permissions granted hereunder.
All provisions hereof concerning my participation and the Program shall be kept strictly confidential by me and my representatives. Neither I nor my representatives shall issue any press releases or public statements about Producer, Company, the Program or my participation hereunder, without Company’s prior written permission.

I acknowledge that during production of the program, I will be working in the proximity of horses, and possibly other animals, as well as in the proximity of stunt activities, including but not limited to the use of firearms shooting blanks. I acknowledge that such proximity may involve risks, including but not limited to bodily injury. I assume full responsibility for all risks that may arise out of or result from my participation in the Program. I agree to conduct myself in a manner that will minimize risk to myself and others. I hereby release, waive, discharge, and hold harmless CPI and any party to which CPI grants any rights in connection with the proceeds and/or Program and all of their parents, affiliates, subsidiaries, licensees, successors and assigns (collectively, “Released Parties”) from any and all claims, suits, liabilities, judgments, costs and expenses (“Claims”) for any personal injury or other loss arising from or relating to my services in the Program. I also agree to defend, indemnify and hold harmless the Released Parties from and against any Claims arising from or related to my own acts or omissions in connection with my services in the Program.

For the right to use my appearance in the Program, Producer shall pay a fee of
$ Dollars. I understand that I am responsible for paying all applicable taxes that may
be imposed thereon, and I release and indemnify Producer and Company from any liability therefor. I further understand that I must properly complete and submit to Producer an IRS Form W-9.]

Sunday, August 18, 2013

CALLTIME FOR TUES: find your name and your calltime below **Please see below for important info.

Hi all,

Thanks for coming out to work on Gunslingers: Icons of the Old West

I do want to let you know before you agree to work that this show will have you sign a waiver saying you won't hold the production company responsible if there are any accidents, etc. I've copied the release below for you to look at just so you are informed before you come on set.  It's at the bottom of the blog. If you have any questions or reservations please let me know. I had to sign the same waiver, as did all the crew.

Lorrie


8:00AM
Union Bushwhackers 
stunts
stunts
stunts
stunts
8:00AM
Brantley Bond FE
stunts

8:00AM
Ruben Samuels FE
Kevin Wester
1:00PM
Tom Horn's Mother
Thayer Hutchinson
10:30AM
Archie Samuels FE
Sky Bleeker
1:00PM
James' Female neighbor
Melarie Roller
1:00PM
Bullies (3)
Dave Pino
Jeremie Dalaba
Aaron Curtis


PAID APPEARANCE RELEASE
For good and valuable consideration, receipt of which is hereby acknowledged, I authorize CASTLE
PICTURES, INC. (“Producer”) and Discovery Communications, LLC (“Company”) and their
respective parents, affiliates, subsidiaries, licensees, successors and assigns to make use of my
appearance for the program tentatively entitled: Gunslingers: Icons of the Old West” (“Program”)
and in connection with Producer and/or Company or otherwise.
I agree that you may tape and photograph me, and record my voice, conversation and sounds,
including any performance of any musical composition(s), during and in connection with my
appearance and that you shall be the exclusive owner of the results and proceeds of such taping,
photography and recording with the right, throughout the world, an unlimited number of times in
perpetuity, to copyright, to use and to license others to use, in any manner, all or any portion thereof or
of a reproduction thereof in connection with the Program or otherwise. For purposes of clarity, I
expressly waive any and all moral rights I may have in connection with my appearance.
I further agree that you may use and license others to use my name, voice, likeness and any
biographical material concerning me which I may provide, in any and all media and in the promotion,
advertising, sale, publicizing and exploitation of the Program and/or otherwise and ancillary products
(e.g., merchandise) in connection with the Program and in connection with Producer and/or Company
or Company’s affiliated services, throughout the world in all media, an unlimited number of times in
perpetuity. I further represent that any statements made by me during my appearance are true, to the
best of my knowledge, and that neither they nor my appearance will violate or infringe upon the rights of
any third party.
I hereby waive any right of inspection or approval of my appearance or the uses to which such
appearance may be put. I acknowledge that you will rely on this permission potentially, at substantial
cost to you and hereby agree not to assert any claim of any nature whatsoever against anyone relating
to the exercise of the permissions granted hereunder.
All provisions hereof concerning my participation and the Program shall be kept strictly confidential by
me and my representatives. Neither I nor my representatives shall issue any press releases or public
statements about Producer, Company, the Program or my participation hereunder, without Company’s
prior written permission.
I acknowledge that during production of the program, I will be working in the proximity of horses, and
possibly other animals, as well as in the proximity of stunt activities, including but not limited to the use
of firearms shooting blanks. I acknowledge that such proximity may involve risks, including but not
limited to bodily injury. I assume full responsibility for all risks that may arise out of or result from my
participation in the Program. I agree to conduct myself in a manner that will minimize risk to myself and
others. I hereby release, waive, discharge, and hold harmless CPI and any party to which CPI grants
any rights in connection with the proceeds and/or Program and all of their parents, affiliates,
subsidiaries, licensees, successors and assigns (collectively, “Released Parties”) from any and all
claims, suits, liabilities, judgments, costs and expenses (“Claims”) for any personal injury or other loss
arising from or relating to my services in the Program. I also agree to defend, indemnify and hold
harmless the Released Parties from and against any Claims arising from or related to my own acts or
omissions in connection with my services in the Program.
For the right to use my appearance in the Program, Producer shall pay a fee of
$ Dollars. I understand that I am responsible for paying all applicable taxes that may
be imposed thereon, and I release and indemnify Producer and Company from any liability therefor. I
further understand that I must properly complete and submit to Producer an IRS Form W-9.]
(Please Print)
Name:
Address: Signature
City/State/Zip: Date
Phone #
Social Security #: Birthda
te:
I am a parent (or guardian) of the minor who has signed this release and consent and I hereby agree
that I and the said minor will be bound by all the provisions contained herein.
Name:
(Please Print) Signature