MODEL’S AUTHORIZATION & RELEASE

For valuable consideration, the receipt and sufficiency of which is acknowledged,

I (Model),____________________, grant (Photographer)___________________

the irrevocable and unrestricted rights to photograph me and use any photographs that Photographer has taken of me on _________________________ , 200_ (Photographs) in any media throughout the world and in perpetuity. I understand that the rights I grant Photographer include the following rights:

1. The right to copyright the photographs in Photographer’s name or any other name.

2. The right to use, reuse, publish, and republish the Photographs in whole or in part, individually or in conjunction with other photographs or printed material, in any media now or hereafter known, and for any purpose. (Such purposes include illustration, promotion, advertising, and publishing of any kind.)

3. The right to alter, modify, or change the Photographs.

4. The right to use my name in connection with the Photographs.

I understand that I will not receive any further compensation from Photographer regardless of how Photographer uses the Photographs. I also understand that Photographer is not required to use the Photographs.

I release and discharge Photographer from any claims and demands arising out of or in connection with the use of the Photographs, including all acclaims for defamation, invasion of privacy, invasion of right of publicity, and copyright infringement.

I agree that this authorization and release shall bind my heirs, representatives, and assigns. I also agree that this authorization and release shall inure to the benefit of Photographer, his or her heirs, representatives, successors, and assigns.

I promise that I am of legal age and have the right to contract in my own name. I have read this authorization and release before I signed it and I fully understand its contents.

For the purpose of this Release, the word “include” or any variation of that word is intended to be inclusive and means “including—but not limited to--.” A facsimile signature shall have the same effect as an original signature on this Release.

Date:____________________

By:___________________________________(Signature)

By:___________________________________(Print Name)

NAME/ADDRESS/TELEPHONE & FACSIMILE:

Taxpayer ID(S.S.):______________________________________

Driver’s License No.:____________________________________