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What type of media does this release cover?
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State of
Date:
Release Scope:
SECTION 1: PARTIES
PHOTOGRAPHER / ORGANIZATION:
Name: ________________ (________)
Address: ________________, ________, ____ _____
Phone: (___) ___-____
Email: ________________
Name: ________________ (________)
Address: ________________, ________, ____ _____
Phone: (___) ___-____
Email: ________________
SUBJECT:
Name: ________________
Date of Birth: __/__/____
Address: ________________, ________, ____ _____
Phone: (___) ___-____
Name: ________________
Date of Birth: __/__/____
Address: ________________, ________, ____ _____
Phone: (___) ___-____
SECTION 2: GRANT OF RIGHTS
The Subject hereby grants to the Photographer/Organization the for [commercial/editorial/personal/unlimited] purposes,SECTION 3: PURPOSE / INTENDED USE
Purpose of Use: [purpose of use]SECTION 4: COMPENSATION
SECTION 5: REPRESENTATIONS AND WARRANTIES
The Subject represents and warrants that:1. The Subject is of legal age to enter into this agreement, or a parent/legal guardian has signed on the Subject's behalf.
2. The Subject has the full right and authority to grant the rights described herein.
3. The Subject's participation is voluntary and the Subject has not been coerced.
4. The Subject waives any right to inspect or approve the finished product or the use to which the media may be applied.
5. The Subject releases the Photographer/Organization from any and all claims arising out of the use of the media as authorized by this release.
SECTION 6: LIMITATION OF LIABILITY
The Subject agrees to hold harmless and release the Photographer/Organization, their agents, employees, licensees, and assigns from any and all claims, demands, and causes of action arising out of or in connection with the use of the Subject's name, image, likeness, or voice as authorized under this release, including but not limited to any claims for defamation, invasion of privacy, or right of publicity.SECTION 7: SIGNATURES
By signing below, all parties acknowledge that they have read and understood this Agreement and voluntarily agree to its terms.SUBJECT SIGNATURE:
Signature: ___________________ Date: ___________
Printed Name: [subject name]
PHOTOGRAPHER / ORGANIZATION SIGNATURE:
Signature: ___________________ Date: ___________
Printed Name: [photographer name]
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