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Model Release Agreement Form by po9383

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ADULT MODEL/PERFORMER AGREEMENT RELEASE

Release #: ______________________________________

Date/s of production/s:_____________________________

Model: _________________________________________

Address:________________________________________

Phone No: ______________________________________

Modelʼs Age (at time of production): __________________

Modelʼs Ethnicity (optional):_________________________

Description of production/s:_________________________

_______________________________________________

_______________________________________________



                                                                                   Attach Visual reference of Model here


THIS MODEL AGREEMENT AND RELEASE (“Agreement”) is dated ___________ and is between the undersigned
photographer (“Photographer”) and the undersigned model/performer (“I”). Agreement as follows:


For good and valuable consideration of ___________________________________ I hereby grant the undersigned
Photographer permission to photograph me. I further give my irrevocable consent to Photographer and his/her direct or
indirect licensees and assignees to publish, republish or otherwise transmit the images of myself in any medium for all
purposes throughout the world. I understand that the images may be altered or modified in any manner. I hereby waive
any right that I may have to inspect and approve a finished product or the copy that may be used in connection with an
image that the Photographer has taken of me, or the use to which it may be applied. I further release the Photographer
and his/her direct or indirect licensees and assignees, from any claims for remuneration Associated with any form of
damage, foreseen or unforeseen, associated with the use of the images.


I am of legal age and have the full legal capacity to execute this authorization without the consent or knowledge of any
other person.


AGREED BY THE MODEL/PERFORMER                                        PHOTOGRAPHER

Signature: ______________________________________ Signature: _______________________________________


Print Name:_____________________________________ Print Name: ______________________________________


Date: __________________________________________ Date: ___________________________________________


                                                                     Address:_________________________________________


                                                                     ________________________________________________




61 Thurlow Park Road, London SE21 8JP | Mob 07597561678| Tel: 0208 133 5965 | www.innocentphotosense.com | service@innocentphotosense.com

								
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