Model Release Agreement
Release
#: _____________________________
Date/s of production/s:
_____________________________
Model:
_________________________________________
Address:
________________________________________
______________________________________________
Phone No:
______________________________________
Model’s Age
(at time of production): __________________
Description of
production/s: __________________________
________________________________________________
________________________________________________
THIS MODEL
AGREEMENT AND RELEASE is dated ___________ and is between the
undersigned
Film-makers and the undersigned model/performer. Agreement as
follows:
I hereby grant the undersigned Film-makers permission to film
me. I further give my irrevocable consent to the Film-makers and their direct
or indirect licensees and assignees to publish republish or otherwise transmit
the moving
images of myself in any medium for all purposes throughout the
world. I understand that the images may be altered or modified in any manner. I
hereby waive any right that I may have to inspect and approve a finished
product or the copy that may be used in connection with an image that the
Film-makers has taken of me, or the use to which it may be applied. I further
release the Film-makers and their direct or indirect licensees and assignees,
from any claims for remuneration Associated with any form of damage, foreseen
or unforseen, associated with the use of the images. I am of legal age and have
the full legal capacity to execute this authorization without the consent or
knowledge of any other person.
AGREED BY THE MODEL/PERFORMER
PHOTOGRAPHER
_____________________________________
__________________________________________
Signature
Print Name:_____________________________ Print
Name:_________________________________
Date:
__________________________________
Address:___________________________________
#: _____________________________
Date/s of production/s:
_____________________________
Model:
_________________________________________
Address:
________________________________________
______________________________________________
Phone No:
______________________________________
Model’s Age
(at time of production): __________________
Description of
production/s: __________________________
________________________________________________
________________________________________________
THIS MODEL
AGREEMENT AND RELEASE is dated ___________ and is between the
undersigned
Film-makers and the undersigned model/performer. Agreement as
follows:
I hereby grant the undersigned Film-makers permission to film
me. I further give my irrevocable consent to the Film-makers and their direct
or indirect licensees and assignees to publish republish or otherwise transmit
the moving
images of myself in any medium for all purposes throughout the
world. I understand that the images may be altered or modified in any manner. I
hereby waive any right that I may have to inspect and approve a finished
product or the copy that may be used in connection with an image that the
Film-makers has taken of me, or the use to which it may be applied. I further
release the Film-makers and their direct or indirect licensees and assignees,
from any claims for remuneration Associated with any form of damage, foreseen
or unforseen, associated with the use of the images. I am of legal age and have
the full legal capacity to execute this authorization without the consent or
knowledge of any other person.
AGREED BY THE MODEL/PERFORMER
PHOTOGRAPHER
_____________________________________
__________________________________________
Signature
Print Name:_____________________________ Print
Name:_________________________________
Date:
__________________________________
Address:___________________________________
Minor Performer/Model Release Form
Release
#: ___________________________________
Date/s of
production/s: _____________________________
Film makers
names:_______________________________
Model:
_________________________________________
Address:
________________________________________
_______________________________________________
Phone No:
______________________________________
Model’s Age
(at time of production): __________________
Description of
production/s: __________________________
________________________________________________
Place photo of model in
box.
In consideration of the engagement as a model of the minor named
above, and for other good and valuable consideration
of__________________________ herein acknowledged as received, upon the terms
hereinafter stated, I hereby grant to______________________ , their legal
representatives and assigns, those for whom film makers are acting, and those
acting with his/her authority and permission, the absolute right and permission
to take, use, reuse, publish, and republish the film featuring the minor or in
which the minor may be included, in whole or in part, or composite or distorted
in character or form, without restriction as to changes or alterations from
time to time, in conjunction with the minor’s own or a fictitious name, or
reproductions thereof in colour or otherwise, made through any medium at
his/her studios or elsewhere, and in any and all media now or hereafter known,
for art, advertising, trade, or any other purpose whatsoever. I also consent to
the use of any published matter in conjunction
therewith.
I hereby waive any right that I or the minor may have to
inspect or approve the finished product or products or the advertising copy or
printed matter that may be used in connection there with or the use to which it
may be applied. I hereby release, discharge, and agree to save harmless and
defend the film makers to their legal representatives or assigns, and all
persons acting under their permission or authority or those for whom they are
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 said picture or in any
subsequent processing thereof, as well as any publication thereof, including
without limitation any claims for libel or violation of any right of publicity
or privacy. I hereby warrant that I am of full age and have every right to
contract for the minor in the above regard. I state further that I have read
the above authorization, release, and agreement, prior to its execution, and
that I am fully familiar with the contents thereof. This release shall be
binding upon the minor and me, and our respective heirs, legal representatives,
and assigns.
Parent or Guardian’s
Signature_____________________________
Parent/Guardian
Name___________________________________
Email
address__________________________________________
Parent or
Guardian phone (if differs from
minor)_______________
Witness
Signature_______________________________________
Witness Name(print)
:__________________________________________
#: ___________________________________
Date/s of
production/s: _____________________________
Film makers
names:_______________________________
Model:
_________________________________________
Address:
________________________________________
_______________________________________________
Phone No:
______________________________________
Model’s Age
(at time of production): __________________
Description of
production/s: __________________________
________________________________________________
Place photo of model in
box.
In consideration of the engagement as a model of the minor named
above, and for other good and valuable consideration
of__________________________ herein acknowledged as received, upon the terms
hereinafter stated, I hereby grant to______________________ , their legal
representatives and assigns, those for whom film makers are acting, and those
acting with his/her authority and permission, the absolute right and permission
to take, use, reuse, publish, and republish the film featuring the minor or in
which the minor may be included, in whole or in part, or composite or distorted
in character or form, without restriction as to changes or alterations from
time to time, in conjunction with the minor’s own or a fictitious name, or
reproductions thereof in colour or otherwise, made through any medium at
his/her studios or elsewhere, and in any and all media now or hereafter known,
for art, advertising, trade, or any other purpose whatsoever. I also consent to
the use of any published matter in conjunction
therewith.
I hereby waive any right that I or the minor may have to
inspect or approve the finished product or products or the advertising copy or
printed matter that may be used in connection there with or the use to which it
may be applied. I hereby release, discharge, and agree to save harmless and
defend the film makers to their legal representatives or assigns, and all
persons acting under their permission or authority or those for whom they are
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 said picture or in any
subsequent processing thereof, as well as any publication thereof, including
without limitation any claims for libel or violation of any right of publicity
or privacy. I hereby warrant that I am of full age and have every right to
contract for the minor in the above regard. I state further that I have read
the above authorization, release, and agreement, prior to its execution, and
that I am fully familiar with the contents thereof. This release shall be
binding upon the minor and me, and our respective heirs, legal representatives,
and assigns.
Parent or Guardian’s
Signature_____________________________
Parent/Guardian
Name___________________________________
address__________________________________________
Parent or
Guardian phone (if differs from
minor)_______________
Witness
Signature_______________________________________
Witness Name(print)
:__________________________________________