Grant of Right to Use Photographic Likeness for Advertising Purposes
I, (Name of Grantor), of (street address, city, state, zip code), hereinafter called the
Grantor, in consideration of $__________, the receipt of which is acknowledged, grant
to (Name of Grantee), of (street address, city, state, zip code), hereinafter called the
Grantee, the right to use and publish for advertising purposes photographic portraits or
photographic likenesses or pictures of me. I may be included in the portraits or
photographic likenesses or pictures in whole or in part, in composite or distorted form, in
conjunction with my own or a fictitious name, or reproductions of the same, or in color or
otherwise, made through any medium. The portraits or pictures are to be taken at the
place of business of (Name of Photographer), of (street address, city, state, zip code)
on (date).
I waive any right that I may have to inspec