Model Release
Name
of photographer:
Number
or description of photograph(s):
Date
of photograph(s):
Intended
use of Photographs:
_
_
For consideration listed
overleaf, I (modelåØ·s name) _ _
give the above-named photographer and all licensees and assignees the
absolute right to copyright and use the photograph(s) described above for the
intended use listed above. It is
understood and agreed by myself and the above-named photographer that any use
of the photographs other than that listed above will require a separate model
release and that a further fee may be levied for that use.
If the photographs are to be
used in an altered or composite form then it is further agreed and understood
that each of the finished images will require written approval and permission
from myself prior to any use or publishing.
Both
parties have read this release and are fully familiar with and understand its
contents.
*I am
over the age of majority and have the right to enter into this contract.
*I am
not over the age of majority, but my parent/guardian agrees to these
conditions.
Name of
Model:
Signature: Date:
Address:
Name of
parent/guardian:
Signature: Date:
Witness
Name: Signature:
Address:
Signature
of Photographer:_
*delete
as applicable Date:_
(cross
out section that does not apply)
section
1
Received from:_
the sum of: _ (Amount in words)
åØ· _
(Amount in figures) in respect of the agreement listed overleaf.
Signed: _
Date: _
section
2
I: _ _
(insert photographers name)
hereby agree to supply: _ (insert
modelåØ·s name)
with (qty): _ _
prints from the shoot described overleaf for her to use in the
promotion of herself as a model only and that it is agreed and understood
that such use should be åØ·as isåØ· in that the prints are not to be altered in any
way. It is further understood and
agreed that if I do not supply said prints within: (time period) _ _
that I shall be liable to
pay a fee of åØ· _ _ (in
words): _ _
to the model listed overleaf.
Models signature: _ _
Date: _ _
PhotographeråØ·s signature: _ _
Date: _ _