Background Music Release Agreement

Any background musical addition MUST be accompanied by a copy of this agreement.


I _______________________ request that the following background music be
applied to my order:

Initial one of the following:

Padlocke Productions Background Music:
______ Easy Listening
______ Country
______ Rock 'n Roll
______ Jazz
______ Contemporary
______ Family
______ Big Band
______ Classical
______ by decade (40s, 50s, 60s, 70s, 80s, 90s)

I will supply my own background music consisting of:
______ CD
______ Audio Tape
______ Other (describe) _______________________________

I hereby understand and agree that this music, whether I have chosen Padlocke Productions background music or I have supplied a CD, audio tape or other source for background music, will NOT be synchronized to the screen action. If I am supplying my own background music, I hereby declare that I, or the company that I represent, am the owner of the rights to such music, or that I have secured permission from the rightful owner to reproduce part or all of such music, or I have attempted to obtain permission and was unable to locate the owner of the music. I authorize Padlocke Productions and/or its employees or agents to copy or reproduce the music on my behalf. I agree to assume all responsibility relating to my right to reproduce the music.

I have read the above agreement and understand it.

Date: ________________________

Customer Name: _______________________________________