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TITLE or SHOOT ID of the work in which Model appears: __________________________

Model ID: _______


PURSUANT TO 18 U.S.C. 2257 & 28 CFR 75.1 et seq.
On behalf of CyberNet Entertainment LLC (hereafter Producer), the undersigned, (hereafter Model), will render services as an actor/model on
the date given below.

Model Legal Name: ________________________________________ Maiden Name: ____________________

(Full Current Legal Name: First, Middle, Last)

All Names: _________________________________________________________________________________

(List all names you have used in the past, including Stage Names, Aliases, Professional Names etc.)

Stage name for this production: ________________________________

Date of Birth: ____________________ Phone: _______________

Email Address: _______________

(Month, Day and Year)

Government Issued Picture Identification

Type: ___________________________
ID #: ____________________________
o Please check this box if you have moved since you last shot with us
o Please check this box if you want us to make your check out to your corporation
Name of corporation: _______________________
o Please check this box if someone referred you to and it is your first time working with us
Name of referrer: __________________________
Model, ____________________________________________, solemnly declares under penalty of perjury that (PLEASE INITIAL):
(legal name)
I have read and thoroughly understand the terms and conditions of the Services I will offer.
I understand that behind-the-scenes footage may be shot throughout the production date, the same grant of rights applies to this
I do not have any health condition or sexually transmitted diseases that would expose others to negative health conditions from
engaging in sexual activities with me. Producer requires safe sex practices.
I am not pregnant
I do not have any severe medical problems
If electro-stimulation is involved, that I do not have any heart problems, including, but not limited to: heart palpitations, murmurs, heart
attacks, strokes, irregular heart beat, high blood pressure, low blood pressure, poor circulation, shortness of breath, and do not wear a
pace maker.
***Please note, we are insured for workers comp. If you are injured during your shoot, please notify the crew or the Talent Department
immediately, otherwise you will be responsible for your own care.***

Model hereby understands that there may be risks and hazards inherent in performing any type of acts involving bondage, penetration, spanking,
or other forms of BDSM play, and hereby elects to voluntarily participate, knowing that such activities may cause marking, injury or pain. As such
Model hereby consents to (please initial where applicable):
Being tied up and/or gagged
Having body touched/spanked when tied up
Being penetrated by a sexual toy, such as a dildo, when tied up
Office use only:


Compensation: for the services rendered and to be rendered under this

Agreement, Producer agrees to pay Model the base compensation of:
Miscellaneous (if any):
Model Referral fee (if any):

Modeling fees:


Transport. and hotel:


Total paid:


$ ___________________________
$ ___________________________
$ ___________________________

Total cash:


Total check:

________________ Check #: _______

must match Total paid:


In addition to the Model services rendered hereunder, Producer shall solely and exclusively own all results, products, and proceeds thereof,
including all rights of whatever kind and character throughout the world and in perpetuity in any and all languages. Without limiting the generality of

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the foregoing, Model grants to Producer and its successors and assigns, the following specific perpetual and exclusive rights in connection with
the results, product and proceeds of the Performance:
a. To produce all or any part of the Models performances (hereinafter the Performance), acts, poses, and appearances of every kind made or
done by Model in connection with the Models Performance.
b. To reproduce Models voice and all other sounds created by Model, if any, (hereinafter the Audio Portion) in connection with the Performance,
and reproduce, issue, sell, and transmit the same, either separately or in conjunction with the Performance, or any part thereof.
c. To exhibit, sell, assign, transmit, and reproduce, and license others so to do (whether by means of motion pictures, still camera photographs,
Internet, radio, television, televised motion pictures, video discs, video cassettes, video tapes, printing, or any other means now known or
unknown) any or all of the Performance and/or Audio Portion.
d. To use the Performance and/or the Audio Portion in connection with advertising, including, without limitation, previews and trailers, one sheets,
flyers, catalogs, and covers or wrappers or sound track recordings, discs, tapes and/or cassettes.
e. To use the Performance and/or the Audio Portion of any part thereof, as a portion of a motion picture, Web site, or other work other than the
Project, and for the advertising thereof, and in connection with the sale of any by-products or merchandise relating thereto, and to reproduce
and/or transmit the same by and in any media;


a. Model further grants to Producer the perpetual but nonexclusive right to use, and to license others to use, Models stage name and any other
stage names that Model has used in the past or may use in the future, including those that may be trademarked, and biography and reproductions
of Models physical likeness and/or voice for the purpose of advertising and exploiting any work embodying the Performance and/or Audio Portion;
and the use any of the rights herein granted for commercial advertising or publicity (including endorsements) in connection with any product,
commodity or service manufactured, distributed or offered by Producer.
b. Model herby assigns and grants to Producer, and its assigns, exclusively and perpetually, all now or hereafter existing rights of every kind or
character whatsoever, whether or not such rights are now known, recognized or contemplated, and the complete, unconditional and
unencumbered title throughout the world and in any and all languages in and to the results and proceeds of Models services and performances
pursuant to this Agreement, and any and all material, works, writings, ideas, gags, characters created, or dialogue composed, submitted or
interpolated by Model in connection with the preparation or production of the Performance. All such materials, and the copyright therein, are
hereby conveyed to Producer.

Model understands and agrees that:
a. The Performance and/or Audio Portion will be utilized in conjunction with sexually graphic or explicit material.
b. Model shall have no right to inspect or approve the finished product, or its use.
c. Model releases Producer, his employees and assigns, from any liability for and by virtue of blurring, distortion, alteration, retouching, optical
illusion, or use of the Performance and/or Audio Portion which may hold Model in a false or unfavorable light, whether such action is intentional or
d. Model, his or her heirs, executives and administrators waive, release, discharge, and covenants not to sue, Producer, its officers, directors and
employees from or for any and all liability resulting in injury, illness or loss of life to Model, whether it is due to the negligence, fault, or intentional
acts of Producer, its officers, directors and employees, another model/actor, or other persons.
e. Model waives his or her insurers right to make a claim against Producer, its officers, directors and employees, based on payments made to
Model, for any reason. This means Models insurer(s) has no right of subrogation.
f. Model releases Producer, and his employer, employees, agents, attorneys and assigns from any and all claims arising out of this agreement or
the use of the Performance and/or Audio Portion including, without limitation, publicity claims, invasion of privacy claims, defamation claims,
sexual harassment claims, injuries (both physical and emotional), negligence, intellectual property, claims relating to disease or illness (including
STDs), pregnancy, and all other such claims.
g. Model hereby specifically acknowledges that certain records containing personal identification information may be transmitted to subsequent
purchasers or licensees of the content produced pursuant to this Model Release. Such information may include, but not be limited to, the
information contained in the accompanying Records Keeping Compliance Form, the attached IDs, and/or the information contained in this Model
Release. Model hereby releases and holds Producer, and his agents, successors, and assigns, harmless from any and all claims associated with,
or arising from, the transfer or dissemination of the information referenced in this paragraph, to third parties.
h. Model further acknowledges that the performance may involve the receipt of, or infliction of, physical pain in the form of beating, whipping,
slapping, hitting, or other forms of consensual physical contact that may leave welts, bruises, sores, cuts, or other physical evidence. The
performance may also involve use of restraints, dominance, humiliation, degradation, power play, and related activities. Model hereby consents to
such physical contact and activities, and irretrievably releases Producer, and Producers agents, principles, successors and assigns, from any and
all liability, responsibility, debts, claims or causes of action, arising in any way from such physical contact, restraints, or activities.

In the event of any arbitration or litigation permitted under this agreement, the prevailing party shall be entitled to an award of attorneys fees,
including attorneys fees on appeal or in any enforcement action.


Each party hereto agrees to execute (with acknowledgement where necessary) and deliver all documents and instruments and to perform such
further acts as may be necessary to carry out the agreements set forth herein including but not limited to Records Keeping Compliance forms
mandated by 18 U.S.C. 2257 and implementing regulations, as they may be amended from time to time.
The undersigned understands that the project is adult oriented entertainment. The undersigned certifies that they have entered into this agreement
of their own free will, and not under the influence of any drugs (whether prescription or illegal), alcohol, or other mind-altering substance. Model
reads, writes and understands the language of this agreement. Model does not suffer from any mental or physical impairment that would prevent
Model from understanding the nature of this Agreement or the terms thereof. Model executes and agrees to the terms hereof voluntarily, free of
any duress or coercion, and is not under the inducement of any promise not set forth in this document. The undersigned represents and warrants
that they are over the age of 18, and have read the foregoing and fully understand the meaning and effect thereof, and are fully authorized to
execute this and fully intend to be legally bound.


Dated: ______________

print legal name: