MODEL RELEASE FORM
To the photographer:

(name)

Address:
Phone:
From the model:

(name)

Address:
Phone:
Photographs taken on

(date)

at

(location)

In exchange for receiving (check/tick as appropriate):
□ modelling fee in the amount of $

□ free prints

I, the model, grant you, the photographer, usage of the photographs subject to the following conditions:
●

●
●

I understand that the photographs taken of me during this sessions can be used wholly or in
part in any publication (commercial or otherwise), portfolio or public display (delete any that
aren't applicable).
The photographs may be used to represent an imaginary person and any wording associated
will not be attributed to me unless my name is specifically mentioned.
Any special conditions on usage agreed between the model and photographer:

Model:

Photographer:

both parties to sign here to agree these special conditions.

I acknowledge that by signing this form, subject to the usage restrictions above, I give up all claim of
ownership of the photographs, and assign copyright to the photographer named above. No further
payment will be due. Use of the photographs may be granted to third parties, however the
photographs will remain the property of the photographer.
I have read this form carefully and fully understand the implications. I am 18 years old or over.

Signed:

(model)

Date:

If the model is under 18 years of age, a parent or legal guardian must sign:
Parent/guardian:
Date:
Address:
Phone:

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