this Agreement and the Registration form, fill them out and send with payment to the address below.

R&B_______ ATLANTA IN CONCERT
RAP_______ RELEASE AGREEMENT
OTHER_______ Appearance #________

I, ____________________________ hereby grant ATLANTA IN CONCERT the following rights in consideration of their possible use of my appearance or of materials supplied to me in a television program to be produced by Starbreakers Entertainment.

1. ATLANTA IN CONCERT will have total ownership of the program, the right to edit the program , the right to broadcast the program, the right to copyright the program and right to license others to use these rights.

2. ATLANTA IN CONCERT may use my name, likeness, voice, biographical information and material supplied by me for the purposes of advertising, publicity, sales promotion, but not as a direct endorsement of any product or service.

3. ATLANTA IN CONCERT's use of my appearance and/or the material provided me as described above will not violate the rights of any person or organization and will not incur any liability for payment to any person or organization.

ACCEPTED AND AGREED: Print Stage Name _______________________________

____________________________ ________________________________________
ATLANTA IN CONCERT SIGNATURE Legal Name

____________________________ ________________________________________
DATE ADDRESS

____________________________ ________________________________________
SONG TITLE TELEPHONE

____________________________ ________________________________________
LABEL VISUAL DESCRIPTION OF ACT

Previously on the show Yes_____ N0______


SHOOT LOCATION___________________________________


STARBREAKERS
P.O. Box Box 590 Duluth, GA 30096