ADULT or Legal Guardian MODEL RELEASE

 

Name of MODEL

Sally Single

 

This release is made the

28th

day of

November,

2004

 

TO:

Rodney Collins

(the photographer)

1.                    In consideration of my engagement as a model (for good and valuable consideration acknowledged as received), I hereby grant the Photographer or anyone lawfully authorised by him, the absolute right and permission to copyright, use, sell for profit, reuse publish, and republish photographic portraits or pictures of me or in which I may be included.

2.                    I give my consent without restriction as to changes or alterations from time to time for use in conjunction with a fictitious name, for reproduction in colour or otherwise made through any media for art, advertising, trade, commercial or any other lawful purpose whatsoever, that do not subject me to ridicule, scandal, reproach, scorn, or indignity.

3.                    I consent to the use of any printed matter titling or wording in conjunction therewith.

4.                    I waive any right that I may have to review or approve the finished product or products, or the advertising copy or printed matter or editorial comment that may be used in connection or in conjunction therewith.

5.                    I hereby release and discharge the photographer, and all persons operating under his authority 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(s) or in any subsequent processing or publication thereof.

6.                    I acknowledge I understand fully the nature of Stock Photography and I hereby grant the photographer, and all those acting under his authority, the absolute right to distribute and sell the picture(s) of me or in which I may be included, to any other party or parties, repeatedly with no limit, for advertising, trade, commercial, editorial, or any other lawful purpose whatsoever, in Australia and any other country world-wide, without restriction.

7.                    I understand that the good and valuable consideration herein acknowledged as received, is the only consideration that I will receive for my engagement as a model, and I understand that I will not receive any further consideration, royalty, or fee for any subsequent use of the said pictures.

8.                    I am of full age and I have read this release (a copy of which I acknowledge receiving) prior to its execution, and I understand and accept the contents.

Number &/or Code of photographs held in the Library covered by this release: 391, 392, 393

 

IN WITNESS WHEREOF this release was executed on the date first above written.

 

Legal Guardian:

Signature:

 

Name:

 

Address:

 

 

Witness:

Signature:

 

Name:

Nadezhda Collins

Address:

GPO Box 2721, Brisbane, Queensland 4001, Australia

Occupation:

Make-Up Artist

If applicable; Receipt of good and valuable consideration

Received this

28th

day of

November,

2004

The sum of

(See Job Brief for details)

or

 

 

as good and valuable consideration for modeling as outlined in the Model Release form above.

Model:

Signature:

 

Name:

Sally Single

Address: