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Model Release: Sf4kA

This document is a model release form that gives a photographer permission to use and license photos of a model for commercial purposes. It transfers all rights in the photos to the photographer. The model agrees their photos can be altered and used in any media. In exchange, the model receives $1 in consideration. The model's personal information will not be publicly available but can be used and shared as needed related to licensing the photos.

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Cikgu Cahaya Bulan Purnama
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
40 views2 pages

Model Release: Sf4kA

This document is a model release form that gives a photographer permission to use and license photos of a model for commercial purposes. It transfers all rights in the photos to the photographer. The model agrees their photos can be altered and used in any media. In exchange, the model receives $1 in consideration. The model's personal information will not be publicly available but can be used and shared as needed related to licensing the photos.

Uploaded by

Cikgu Cahaya Bulan Purnama
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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]:.

Model Release
For Consideration herein acknowledged as received, and by signing
this release I hereby give the Photographer / Filmmaker and Assigns
my permission to licnse the Content and to use the Content in any
Media for any purpose (except pomographic or defamatory) which
may include, among others, advertising, promotion, marketing and
packaging for any product or service. I agree that the Content may be
c,ombined with other images, text, graphics, film, audio, audio-visual
works; and may be cropped, altered or modified. I acknowledge and
agree that I have consented to publication of my ethnicity(ies) as
indicaled below, but understand that other ethnicities may be
associated with me by the Phoiographer / Filmmaker and / or Assigns
for descriptive purposes.
I agree that I have no rights to the Content, and all rights to the
Content belong to the Photographer / Filmmaker and Assigns. I
acknowledge and agree thal I have no further right io additional
consideration or accounting, and that I will make no further claim for
any reason to Photographer / Filmmaker and / or Assigns. I
acknowledge and agree that this release is binding upon my heirs
and assigns. I agree that this release is inevocable, worldwide and
perpetual, and will be govemed by the laws (excluding the law of
contlicts) of the country/state from the following list that is nearest to
the address of the Model (or Parent-) given opposite: New York,
Alberta, England, Australia and New Zealand.

It is agreed that my personal information will not be made publicly


available but may only be used directly in relation to the licensing ot
the Gontent where necessary (e.9. to defend claims, protect rights or
notify trade unions) and may be retained as long as necessary to
fullill this purpose, including by being shared with sub-licensees /
assignees of the Photographer / Filmmaker and transfened to
countries with difiering data protection and privacy laws where it may
be stored, accessed and used. I represent and wanant that I am at
least 18 years of age and have the full legal capacity to execute this
release.

Definitions: "ASSIGNS" means a person or any company to whom


Photographer/Filmmaker has assigned or licensed rights under this
release as well as the licensees of any such person or company,
'CONSIDERATION'means $1 or something else of value I have
received in exehange for the rights granted by me in this release.
'CONTENT means all photographs, film, audio, or other recording,
still or moving, taken of me as part of the Shoot. "MEDIA" means all
media including digital, electronic, print, television, film, radio and
other media now known or to be invented. "MODEP means me and
includes my appearance, likeness and voice. "PAHENT means the
parent and/or legal guardian of the Model. Parent and Model are
refened to together as'1" and "me" in this release, as the context
dictates. "PHOTOGRAPHER / FILMMAKER" means photographer,
illustrator, filmmaker or cinematographer, or any other person or entity
photographing or recording me. .SHOOT" means the photographic,
film or recording session described in this form.

Photographer and Shoot lnformation


Name:
Shoot Date:
Shoot Location / Description:

Photographer Signature:

Model lnformaticn
run rvanre.

Mo.t{o ttr6BFERZty

DateorBirth: 15
Gender:

lnc.

A0

/ 03 / I q8?

uate

Female

Parent / Guardian Full Name (if under 'l8yrs):

Street Address:

Sf4kA Ct-) Alm*sr{6ce- illw are- rr+lq


c? eog q|Ta)rl province
City:
r stare: ?OAu P w*ug

HAlaYsr a
pnon". f6 o l>*7.4lTtct
,*,. a arr"lre.^laq-L,9O@arnC[.
Couniry:

Ethnicity infunnalion is OPTIONAL ard is requested


fur cbscrigive
onry, arxC sens as a rneans
of providirg rore mrccy in asignirq search terms.

Flrrc

Ethnicity:
Model Signature or Parent

Date Signed:

$@x

MO|+R

ec

i Guardian (if under 18yrs):

/oq

/xts

Revision Date: Marcfl 14,2014

cq

]:.

Model Release
For Consideration herein aeknowledged as received, and by signing
this release I hereby give the Photographer / filmmaker and Assigns
my permission to license the Content and to use the Content in any
Media for any purpose (except pomographic or defamatory) which
may include, among others, advertising, promotion, marketing and
packaging for any product or service. I agree that the Content may be
combined with other images, text, graphics, film, audio, audio-visual
works; and may be cropped, altered or modilied. I acknowledge and
agree that I have consented to publication of my ethnicity(ies) as
indicated below, but understand that other ethnicities may be
associated with me by the Photographer / Filmmaker and / or Assigns
for descriptive purposes.
I agree that I have no rights to the Content, and all rights to the
Content belong to the Photographer / Filmmaker and Assigns. I
acknowledge aM agree that I have no further right to additional
consideration or accounting, and that I will make no further claim for
any reason to Photographer / Filmmaker and / or Assigns. I
acknowledge and agree that this release is binding upon my heirs
and assigns. I agree that this release is inevocable, worldwide and
perpetual, and will be governed by the laws (excluding the law of
conflicts) of the country/state from the following list that is nearest to
the address of the Model (or Parent-) given opposite: New York,
Alberta, England, Australia and New Zealand.

Photographer and Shoot lnformation


Name:
Shoot Date:
Shoot Location / Description:

Photographer Signature:

ilodel lnformation
run ru"n

pocFEczz-v Mo*Aa4p
*, Mot{p

DateorBirth: 15
Gender:

/ 03 / I q8?

uate

Female

Parent / Guardian Full Name (if under l8yrs):

It is agreed that my personal information will not be made publicly

available but may only be used directly in relation to the licensing of


the Content where necessary (e.g. to defeM claims, protect rights or
notify trade unions) and may be retained as long as necessary to
lullill this purpose, including by being shared with sub{ic,ensees /
assignees ot the Photographer / Filmmaker and transfened to
countries with differing data proteclion and privacy laws where it may
be stored, acressed and used. I represent and wanant that I am at
least 18 years of age and have the full legal capacity to execute this
release.
Definitions: "ASSIGNS" means a person or any company to whom
Photographer/Filmmaker has assigned or licensed rights under this
release as well as the licensees of any such person or company.
'CONSIDERATION'means $1 or something else of value I have
received in exchange for the rights granted by me in this release.
"CONTENT'means all photographs, film, audio, or other recording,
still or rnoving, taken of me as part of the Shoot. "MEDIA' means all
media including digital, electronic, print, television, film, radio and
other media now known or to be invented. "MODEP means me and
includes my appearance, likeness and voice. "PAHENP means the
parent and/or legal guardian ol the Model. Parent and Model are
refened to together as "1" and "me" in this release, as the context
dictates. "PHOTOGRAPHER / FILMMAKER" means photographer,
illustrator, filmmaker or cinematographer, or any other person or entity
photographing or recording me. "SHOOT" means the photographic,
film or recording session described in this form.

Street Address:

sl4l<A ct-) *Lm*srr6cR duv erc- tr+rrr


City:

6a q6tat+tprovince t state: ?o$u P w*ug

HAlaYsr a
pnon". fa o l>*+4t +frt
,*r,. aa arralrcronro-k9O@U*df. crz
Country:

Ethnhity infonnafpn is OPTIONALand is requested


arxC sefis as a rneans
of providirg rore mrr*y in aeeignirq search terms.

furdescriptiw Frrpos* only,


Ethnicity:

Model Signature or Parent / Guardian (if under 18yrs):

Date Signed:

SO@x lnc.

t c /oq /xts

Revision Date: March 14,2014

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