Release and Authorization to Photograph
Release executed on (date), by (Name of Releasor), of (street address, city,
state, zip code), (Releasor), in favor of (Name of Photographer, of (street address, city,
state, zip code), (Releasee).
For and in consideration of $____________, receipt of which from Releasee is
acknowledged, Releasor consents to being the subject of the photographs of Releasee,
together with any subject matter owned by Releasor, and authorizes Releasee to cause
the same to be exhibited, with or without advertising sponsorship, as still photographs,
transparencies, motion pictures, television, video or other similar media.
Furthermore, Releasor releases Releasee, and any associates, as well as any
assignees, from any and all claims for damages for libel, slander, invasion of privacy or
any other claim based on use of the above-described materials.