Sample Model Release

I, (Please Print)____________________(Model), for good and valuable consideration, the receipt of which is acknowledged, give to {INSERT YOUR LEGAL NAME HERE} (Photographer), his legal

representatives, successors, and all persons or corporations acting with his permission, unrestricted permission to copyright and/or use, and/or publish photographic portraits or pictures of me, and the negatives, transparencies, prints, or digital information pertaining to them, in still, single, multiple, moving or video format, or in which I may be included in whole or in part, or composite, or distorted in form, or reproductions thereof, in color or otherwise, made through any media in his studio or elsewhere for art, or any other lawful purpose.

I hereby waive any right that I may have to inspect and approve the finished product or copy that may be used in connection with an image that the Photographer has taken of me, or the use to which it may be applied.

I further release the Photographer, or others for whom he is acting, from any claims for remuneration associated with any form of damage, foreseen or unforeseen, associated with the proper commercial or artistic use of these images unless it can be shown that said reproduction was maliciously caused, produced and published for the sole purpose of subjecting me to conspicuous ridicule, scandal, reproach, scorn and indignity.

I acknowledge that the photography session was conducted in a completely proper and highly professional manner, and this release was willingly signed at its termination. I certify that I am not a minor under the laws where I live, and am free and able to give such consent. Model's signature:_________________________ day___/month___/year_____

Address:___________________________________

City:______________________________________

State/Province:______________________________

Country:___________________________________

Zip/Postal Code:_____________________________

Country area code and home telephone number:( )____________________________

Witness(non family member):_________________________________________________

This form will be retained with the negatives, transparencies, digital diskette(s), and/or contact sheets.

day___/month___/year_____ {INSERT YOUR LEGAL NAME HERE}