|
Model Release
In consideration of compensation as indicated below, receipt of which
is hereby acknowledged, I _____________________________ (hereafter "Model") do
hereby irrevocably authorize, Athen Grey (hereafter
"Photographer"), Photographer's legal representatives, assigns, and those
acting under Photographer's permission and on Photographer's authority, to
copyright, publish, and use in all forms and media and manners for
advertising, trade, promotion, exhibition, or any other lawful purpose
whatsoever, any depictions of myself made by Photographer or
Photographer's representative, in which I may be included in whole or in
part, alone or in conjunction with other persons, or composite or
distorted in character, or form, or based on or involving any stunt poses,
in conjunction with my own or a fictitious name, or reproductions thereof
in color or otherwise, or in derivative works made through any medium,
where said depictions may include any or all of still, single, multiple or
moving photographic images or pictures, video recordings or audio
recordings (collectively hereafter the "Depictions.")
Model does hereby waive any right to inspect or approve the finished
product or advertising or other copy that may be used in connection
therewith or the use to which they may be applied.
Model hereby releases and agrees to hold harmless Photographer, his
legal representatives, assigns, and all persons acting under his
permission or authority, from any liability by virtue of blurring,
distortion, alteration, optical illusion, or use in composite form whether
intentional or otherwise, that may occur or be produced in the taking of
the pictures, or in any processing tending toward the completion of the
finished product, unless it can be clearly shown that the publication
thereof were maliciously caused, and produced, and published solely for
the purpose of subjecting Model to conspicuous ridicule, scandal,
reproach, scorn, and indignity.
Model hereby affirms that all poses, positions and situations enacted
in the Depictions covered in this release were entered into without force,
coercion, or threat whatsoever, and were posed freely by Model with
Model's full consent in return for compensation and for Model's own
amusement. Model further agrees to hold blameless and free of all
accusation of such force or coercion Photographer, his legal
representatives, assigns, and those acting under his permission and on his
authority.
Model hereby affirms that his/her date of birth is __________________
and that Model is fully able to contract in his/her own name without
breach of any prior agreement or applicable law.
Model's compensation in connection with this instrument is: (cross out
any that do not apply)
(a) Modeling fee of ____________ dollars.
(b) Other compensation (describe):
________________________________________________________
________________________________________________________
_______________________________________________________.
I have read the above authorization and release prior to its execution
and I am fully familiar with and agree to the contents thereof.
| |
| ___________________________________________ |
|
___________________________________________ |
| Model's Signature |
|
Model's Phone |
| ___________________________________________ |
|
___________________________________________ |
| Today's Date
|
|
Model's email address |
| |
| ___________________________________________ |
|
___________________________________________ |
| ___________________________________________ |
|
___________________________________________ |
| ___________________________________________ |
|
___________________________________________ |
| ___________________________________________ |
|
___________________________________________ |
| Model's mailing address |
|
Talent agency name and address (if applicable) |
|
|
Model Release (Minor Model)
In consideration of compensation as indicated below, receipt of which
is hereby acknowledged, I ________________________ (hereafter
"Model"), and ________________________________ (hereafter "Parent") as
Model's parent or legal guardian, do hereby irrevocably authorize
Athen Grey (hereafter "Photographer"), Photographer's
legal representatives, assigns, and those acting under Photographer's
permission and on Photographer's authority, to copyright, publish, and use
in all forms and media and manners for advertising, trade, promotion,
exhibition, or any other lawful purpose whatsoever, any depictions of
Model made by Photographer or Photographer's representative, in which
Model may be included in whole or in part, alone or in conjunction with
other persons, or composite or distorted in character, or form, or based
on or involving any stunt poses, in conjunction with Model's own or a
fictitious name, or reproductions thereof in color or otherwise, or in
derivative works made through any medium, where said depictions may
include any or all of still, single, multiple or moving photographic
images or pictures, video recordings or audio recordings (collectively
hereafter the "Depictions.")
Model and Parent do hereby waive any right to inspect or approve the
finished product or advertising or other copy that may be used in
connection therewith or the use to which they may be applied.
Model and Parent hereby release and agree to hold harmless
Photographer, his legal representatives, assigns, and all persons acting
under his permission or authority, from any liability by virtue of
blurring, distortion, alteration, optical illusion, or use in composite
form whether intentional or otherwise, that may occur or be produced in
the taking of the pictures, or in any processing tending toward the
completion of the finished product, unless it can be clearly shown that
the publication thereof were maliciously caused, and produced, and
published solely for the purpose of subjecting Model to conspicuous
ridicule, scandal, reproach, scorn, and indignity.
Model and Parent hereby affirm that all poses, positions and situations
enacted in the Depictions covered in this release were entered into
without force, coercion, or threat whatsoever, and were posed freely by
Model with Model's and Parent's full consent in return for compensation
and for Model's own amusement. Model and Parent further agree to hold
blameless and free of all accusation of such force or coercion
Photographer, his legal representatives, assigns, and those acting under
his permission and on his authority.
Parent hereby affirms that he/she is the mother, father, or legal
guardian of Model and that Model's date of birth is
_________________________________ and that Parent's date of birth is
_____________________________.
Parent hereby affirms that neither Model's nor Parent's execution of
this instrument causes a breach of any prior agreement or applicable law,
including but not limited to a prior agreement with a modeling agency,
talent agency, or other photographer.
The compensation in connection with this instrument is: (cross out any
that do not apply)
(a) Modeling fee of _______________ dollars.
(b) Other compensation (describe):
________________________________________________________
________________________________________________________
_______________________________________________________.
We have read the above authorization and release prior to its execution
and are fully familiar with and agree to the contents thereof. Signing of this Minor Model Release by Model
and Parent must be witnessed by Photographer.
___________________________________________ |
___________ |
| Model's Signature |
Date
|
___________________________________________ |
___________ |
| Parent's signature |
Date |
| ___________________________________________ |
| Model's Phone |
| ___________________________________________ |
| Model's Email |
___________________________________________ |
| ___________________________________________ |
| ___________________________________________ |
| ___________________________________________ |
| Model's mailing address |
___________________________________________ |
| ___________________________________________ |
| ___________________________________________ |
| ___________________________________________ |
| Talent agency name and address (if applicable) |
|
|
|
|