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Blue Ridge Modeling
Model Release form
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Sample Model Release form...


MODEL RELEASE FORM
_______________________________
Model release number
_______________________________
Photographer name
_______________________________
Model name
_______________________________
Address
_______________________________
City
_______________________________
Zip/ Postal Code
_______________________________
Phone Number
_______________________________
Email

For valuable consideration, hereby received, I irrevocably consent to and authorize the use and reproduction by you, or anyone authorized by you, of any and all photographs which you have this day taken of me, negative or positive, mechanical or electronic, for any purpose whatsoever, without restriction, and without further compensation to me.
All negatives, positives, video or audiotapes, electronic files, together with any prints shall constitute your property, solely and completely.
I hereby release, discharge and save harmless the photographer, his/her representatives, assigns, employees, or any person or corporation acting under the permission of the photographer, including any firm publishing or distributing the finished product, even though the finished product may be distorted, blurred, altered or used in composite forms, in conjunction with factual or fictional text, either intentionally or otherwise and subject me to scandal, scorn, ridicule, reproach or indignity. I hereby waive any right to approve the finished photograph, or any copy, which might be used in conjunction with the finished photograph.
If I am below the age of majority, (usually 18 but sometimes 21,) in the legal jurisdiction applicable to this agreement, the agreement has been signed or approved by the parent or guardian.
_______________________________
Signature
_______________________________
Date

I hereby certify that I am the parent or legal guardian of the above named model, and for value received I do give my consent without reservations to the forgoing on behalf of him, her, or them.
_______________________________
Name
_______________________________
Relationship to Model
_______________________________
Signature
_______________________________
Date
Witness: _______________________
Name: _________________________
Address: _______________________


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