Model Release Form

MODEL RELEASE FORM

(1) ______________ [the “Model”], for good and valuable consideration, the receipt of which is acknowledged, hereby grants to ______________ [“Company”], its legal representatives, assignees, and those acting under its authority, the unrestricted right and permission to copyright and/or use, and/or publish photographic portraits or pictures of the Model [the "Pictures"], and the negatives, transparencies, prints, or digital information pertaining to them, in still, single, multiple, moving or video format, or in which Model may be included in whole or in part, or composite, or distorted in form, or reproductions thereof, in color or otherwise, in any media for advertising or any other lawful purpose.

(2) Model hereby relinquishes any right that [he/she] may have to examine or approve the finished product or products or the advertising copy or printed matter that may be used in connection with an image that Company has taken of the Model, or the use to which it may be applied. Model waives any ownership and publication right [he/she] might be entitled in connection with the Pictures, with the exception of the personal use of the Pictures as part of personal modeling portfolio. Model agrees he/she has no right to sell, license or publish any of the Pictures to any person or entity.

(3) Model further releases Company its parent company, subsidiaries, affiliates, officers, agents, servants, or employees [“Releasees”] from any claims for remuneration associated with any form of damage, foreseen or unforeseen, associated with the proper commercial or artistic use of these images unless it can be shown that said reproduction was maliciously caused, produced and published for the sole purpose of subjecting the Model to conspicuous ridicule, scandal, reproach, scorn and indignity.

(4) Model also waives any and all claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, that may be sustained by Model, or any of the property belonging to Model, whether caused by the negligence of the Releasees, or otherwise, while performing the photography session, or while in, on or upon the premises where the photography session was performed.

(5) It is the express intent of Model that this document shall bind all members of Model’s family, heirs, assignees and personal representatives.

(6) Model hereby warrants that [he/she] is 18 years of age or older and has the right to contract in [his/her] own name. If Model is under 18 years of age, a parent’s signature is required on the next page. Model has read the above authorization, release, and agreement, prior to its execution, and is fully familiar with the contents of this document. Model represents that this release was willfully signed.

___________________________

Model's Signature

___________________________

Model's Name

___________________________

Model's Date of Birth

___________________________

Address (LINE 1)

___________________________

Address (LINE 2)

___________________________

Today's Date
 

Important: If the Model is under 18 year of age, a parent or legal guardian must also sign.

Parent/Guardian Signature: _______________________ date: __________