Model Releose
For Considerotion herein ocknowledged os received, ond by signing
this releose I hereby give ihe Phologropher / Filmmoker ond Assigns
my permission lo license the Content ond lo use the Contenl in ony
Medlo for ony purpose (except pornogrophic or defomotory) which
moy include, omong others, odvertising, promotion, morketing ond
pockoging for ony product or service. I ogree thot the Content moy be
combined wilh other imoges, text grophics, film, qudio, oudio-visuol
works; ond moy be cropped, oltered or modified. I ocknowledge
ond ogree thol I hove consenled to publicotion of my ethniciiy(ies)
os indicoled below bul understond ihot other ethniciiies moy be
ossocioled wilh me by the Phologropher / Filmmoker ond / or
Assigns for descriptive purposes.
Attoch Yrsuol Refueoce of Model hee:
(Aligned io lop righl-hond corner if lorger lhon box.)
For exomple, Poloroid, drivers license, prinl, photocopy, elc.
logree ihol I hove no righis to the Conlenl, ond oll rights to the
Conlent belong to lhe Photogropher / Filmmoker ond Assigns. I
ocknowledge ond ogree lhol I hove no furlher righl to oddilionol
considerotlon or occounling, ond thol lwill moke no further cloim
for ony reoson io Phologropher / Filmmoker ond / or Assigns. I
ocknowledge ond ogree thol this releose is binding upon my heirs
ond ossigns. logree thol this releose is irrevocoble, worldwide ond
perpeluol, ond will be governed by the lows (excluding lhe low of
conflicts) of the country/slote from the following list thol is neoresi
to the oddress of the Model {or Porent*) given opposite: New York,
Alberto, Englond, Austrolio ond New Zeolond.
It is
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Model lor Porenfl lnformotion
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ogreed thot my personol informotion will not be mode publicly
ovoiloble but moy only be used directly in relotion lo the licensing of
the Conlent where necessory {e.9. lo defend cloims, protecl rights
or nolify trode unions) ond moy be retoined os long os necessory
lo fulfill this purpose, including by being shored with sub-licensees
/ ossignees of ihe Photogropher / Filmmoker ond tronsfened to
countries with differing dolo prolection ond privocy lows where it moy
be slored, occessed ond used. I represent ond worronl ihot I om ot
leost 18 yeors of oge ond hove the full legql copocity to execute this
releose.
Definitions: "ASSIGNS" meons o person or ony compony io whom
Photogropher/Filmmoker hos ossigned or licensed rights under this
releose os well os the licensees of ony such person or compsny.
"CONSIDERATION" meons $l or something else of volue I hove received
in exchonge for ihe righls gronted by me in lhis releose. "CONTENT"
meons oll phoiogrophs, film, oudio, or other recording, still or moving,
loken of me os port of ihe Shooi. "MEDIA" meons oll medio including
digitol, electronic, prini, lelevision, film, rodio ond oiher medio now
known or to be invenled. "MODEI meons me ond includes my
oppeoronce, likeness ond voice. "PARENT" meons the porent ond/or
legol guordion of the Model. Porenl ond Model ore referred to logelher
os "1" ond "me" in lhis releose, os lhe contexi dictotes. "PHoTOGRAPHER
/ FILMMAKER" meons photogropher, illustrotor, filmmoker or
cinemoiogropher, or ony oiher person or enlity photogrophing or
recording me. "SHOOT" meons ihe photogrophic, film or recording
session descrlbed in this form.
Signolure
Dote signed
*lf Model is o minor or locks copocity in the
iurisdiction of residence, Porent
wqrronls ond represents lhot Porenl is the legol guordion of Model, ond hos
the full legol copocity lo consenl to the Shoot ond to execule this releose oF
ALL RIGHTS lN MODEIS CONTENT. lf you ore signing in this copocily, pleose
enter your detoils obove ond your nome below.
Porent Nome:
if opplicoble.
Additionol informolion to be complelred by Model: (Optiono|
Elhnicity informolion is requested for descriptive purposes only, ond serves
os o meons of providing more occurocy in ossigning seorch words.
_Asion
i
_.rL
- circle oll thol opplies to you:
(Chinese, Joponese, Koreon, lndion, othed
Coucosion, While
Middle Eostern
Olher:
-Block
Lolin
Americon
-Hisponic,
-Nolive Roce
-Mixed
-Pocific
-Africon
lslonder
Americon
Photogropher/Filmmoker lnf ormotion
Nome (prinr)
(NOTE: All persons signing ond witnessing must be of legol oge ond
copocity in the oreo in which this Releose is signed. A person connot witness their
own releose)
Witness
Signoture
Dote signed
Nome (print)
Shool Dote
Shoot Country & Region/Slole
Shool Description/Ref.
tif
qpplioblel
Signoture
Dote signed
Model Releose
-
English
-
Dec 2008