CHECK AUTHORIZATION FORM FOR TAL

CHECK AUTHORIZATION FORM FOR TALENT UNDER 18

(Parents: Please fax a copy of this form to the production office and then a fax copy to CTK at 706-295-7527)

I, ______________________________, hereby authorize that all payments for my child’s,

(parent/guardian name)

_______________ _________________ , participation in the project titled/named

(child’s name)

“______________________________” for the role of ________________________

(film/tv/project name)

be made payable to ________________________ c/o CTK

(child’s name) (Coastal Talent Kids Teens Adults)

and mailed to: CTK Agency 3 Central Plaza, Suite 344, Rome, GA 30161-3233.

__________________________________ ___________________

Signed (Parent/Guardian) Date

For ________________________________

(child’s name)

AGENCY Info:

CTK AGENCY

3 Central Plaza, Suite 344

Rome, GA 30161-3233

ATTN: Barbara Garvey

CONTACT: 404-660-7709 or 843-571-2663 FAX: 706-295-7527

CHECK AUTHORIZATION FORM FOR TALENT 18+

(Please fax a copy of this form to the production office and then a fax copy to CTK at 706-295-7527)

I, ______________________________, hereby authorize that all payments for my

(talent name)

participation in the project titled/named “______________________________” for the role

of ________________________ be made payable to