Model Release Form

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This model release is made by Name , an individual (the "Model"), in favor of Name Business / Individual , an individual State Photographer Business Type (the "Photographer"). In consideration of the payment of $$ Amount , the Model agrees as follows:

1. PERMISSION TO TAKE AND USE PHOTOGRAPHS.
Name and biographical info / Name only / Neither

(a) Permission to Use. The Model grants the Photographer the full irrevocable right to take pictures, portraits, digital images, or photographs of the Model or in which the Model may be included (the "Photographs") and use, publish, reproduce, edit, exhibit, license, distribute, or otherwise exploit the Photographs, in whole or in part and in conjunction with the Model's name (or fictitious name) For anything in any media / For a specific project only for any lawful purposeYes / No
(b) No Obligation. The Photographer's right to use the Photographs does not constitute an obligation to make use of this right.

2. ASSIGNMENT; WAIVER.

The Model assigns to the Photographer all interest in the Photographs, including copyright. The Photographs and any associated negatives are the sole property of the Photographer and the Model waives any right to:

(a) inspect or approve the Photographs;
(b) inspect or approve any text, graphics, images, or other content created in connection with or combined with the Photographs; or
(c) receive any royalties or other compensation related to the Photographic Use.

3. RELEASE.

The Model hereby releases the Photographer from any liability arising from the Photographic Use, including that based on copyright infringement, invasion of privacy, right of publicity, libel, defamation, or false light, or resulting from any alteration, blurring, optical illusion, use in composite form, distortion, or other modification that may occur, intentionally or otherwise, in connection with taking the Photographs, processing the Photographs, or the Photographic Use.

4. MODEL'S REPRESENTATIONS.

The Model hereby represents that:

(a) he or she is a legal adult and has the full legal capacity to execute this release;
(b) the rights granted under this release do not conflict with or violate any other commitment the Model has; and
(c) he or she has read this release before signing it and fully understands its contents, meaning, and impact.

The Model is signing this release on the date stated opposite his or her signature.

	MODEL:

Date:____________________________	By:______________________________________________ Model Name Street address City , State ZIP Code
	Social Security Number:_____________________________
Yes / No
Witnessed By:____________________________________	Date:____________________________

________________________________________________ Witness Name

________________________________________________ Address