Model release

Photographer's  Name:                

Country:

Photographer's Adress:                    

Phone:

ZIP/Postal code:                    

Email:

 

In valuable and good consideration of my engagement as a model  (Participant), upon the terms and herewith stated, I hereby give to ............................................................................ ( The Photographer), her, heirs , legal representatives  and assigns , those for whom photographer is acting, and those acting with his authority and permission:

  1. The unrestricted right and permission forever to copyright and use, re- use, publish, and republish photographic portraits or pictures of me or in which I may be included intact or in part, composite or distorted in character or form, without restriction  as to changes or  transformations in conjunctions with my own or fictitious name or reproduction hereof in colour or otherwise, made through any and all media now or hereafter known for illustration, art, promotion, advertising, trade or any other purpose whatsoever.
  2. I also permit to use of any text material in connection  therewith.
  3. I hereby relinquish any right that I may have to examine or approve the completed product or products or the advertising copy or printed matter that may be used in conjunction wherewith or the use to which it may be applied.
  4. I hereby release, discharge and agree to save harmless the Photographer, his/her, heirs, legal representatives or assigns, and all persons functioning under  his/her permission or authority, or those for whom he/she is functioning, from any liability by virtue of any blurring, distortion, alteration, optical  illusion, or use in composite form whether  intentional or otherwise, that may occur, or be produced in the taking of said picture or in any subsequent processing thereof, as well as any publication thereof,  including without limitation any claims for libel or invasion of privacy.  
  5. I hereby affirm that I am over the age of majority and have the right to contract in my in my own name.  I have read the above authorization, release and agreement prior to its executions;  I fully understand the contents thereof.  This agreement shall be binding upon me and my heir, legal representatives and assigns.

 

I am also aware that these are subject to negotiations, deletions or addendum, which I may be valid if handwritten on this release and initialled and dated by both parties (The Photographer and Undersigned) next to the modification or any modification that is typed and signed by both parties.  Modification may be implied by any releases/contracts with my employer without my notice by the Photographer.

 

Participation Information:

Name:

Address:

Signature:

Telephone:

Date:

 

 

I hereby certify that I am the parent/ legal guardian of the above named Model. and for value received I do give my consent without reservation to forgoing on behalf of him, her or them.

 

 

Parent or Guardian information:

Name:

Address:

Signature:

Telephone:

Date:

 

Photographers information:

Name:

Address:

Signature:

Telephone:

Date: