• Copy the text of the agreement below 
  • Paste as an email message via your personal email account
  • Add the name of work used in the film, your name, and date to the end of  the agreement where noted
  • Place in the email subject line: Music Clearance Agreement
  • Email agreement to


To Whom It May Concern:

I hereby agree to allow Dreadhead Films/ImageFlick (“the Filmmaker”) to use my work below in the motion picture tentatively entitled Foreshadow (the “Picture”).

I own the legal copyright to the named work below, and hereby agree to the use of this work in the promotion, production, and distribution of the Picture.

I hereby certify and represent that I am over 18 years of age and have read this music clearance agreement and fully understand the meaning and effect thereof. Further, I understand that my typed name below and email submission of this agreement will formally serve as my signature.

Name of Work:

Composer Name: