Model Release FOR MINOR

For good and valuable consideration, herein acknowledged as received and sufficient, and by signing this release, I

___________________________________________________________________________________(“Parent or Guardian of model”)

hereby grant _____________________________________________________________________ (the “Photographer”), the Photographer’s legal representatives and assigns, those for whom the Photographer is acting, and those who acting with his authority and permission, the irrevocable and unrestricted right and permission to copyright, in his own name or otherwise, and use, re-use, publish, and re-publish photographic portraits or pictures of model I represent (“Model”) or in which Model may be included, taken by Photographer (“Images”), in whole or in part, as part of a composite or distorted in character or form, without restriction as to changes or alterations, in conjunction with Model own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium at his studios or elsewhere, and in any and all media now or hereafter known for illustration, promotion, art, editorial, advertising, trade, publishing, or any other purpose whatsoever. I also consent to the use of any printed matter in connection therewith.

I warrant and represent that I am the father/mother/guardian of

________________________________________________________________________________________________ (the “Model”).

I acknowledge and agree that I have consented to publication of Model ethnicity(-ies), but understand that other ethnicities may be associated with Images of Model by the Photographer and/or Assigns for descriptive purposes.

I hereby waive any right that I and Model may have to inspect or approve the finished product or products and the advertising copy or other matter that may be used in connection therewith or the use to which it may be applied.

I agree that I and Model have no rights to the Images, and all rights to the Images, including the copyright, belong to the Photographer and Assigns. I acknowledge and agree that I and Model have no further right to additional consideration or accounting, and that I and Model will make no further claim, for any reason, including any claims for libel or invasion of privacy, to Photographer and/or Assigns. I acknowledge and agree that this release shall be binding upon me, my heirs, legal representatives and assigns. I agree that this release is irrevocable, worldwide and perpetual.

I hereby release, discharge, and agree to save harmless the Photographer, his heirs, legal representatives and assigns, and all persons acting under his permission or authority or those for whom he is acting, 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 such photographic portraits or pictures or in any subsequent processing thereof, as well as any publication thereof, including without limitation any claims for libel or invasion of privacy.

I have read the above authorization, release, and agreement, prior to its execution, and I am fully familiar with the contents thereof.

Photographer Model

Name (print): ____________________ Name (print) _____________________________________

Date Signed ______________ Signature _______________ Date Of Birth__________________Gender_____________

Phone: ___________ Address: _________________ Phone ____________ Address ______________________

City:_____________ State:________ Zip: ________ City _________________ State _________ Zip _________

Country: ______________ Email: ___________________ Country _________________ Email: __________________

Parent(s) or Guardian(s)

Name (print) _______________________________________________ Date Of Birth___________________

Signature___________________________________________________ Date Signed___________________

Phone__________________Address______________________________________ City _______________ _

State __________ Zip _______Country _____________ Email: _____________________________________

Shoot Country & Region/State___________________________

Shoot Date ______________ Shoot Description:_______________________________________________________________

Witness

Name (print) _________________________________________Date Signed _____________ Signature __________________

Date: 2015-12-11; view: 796