MODEL RELEASE
DATE___________________
PHOTOGRAPHER/ARTIST________________________________
ADDRESS______________________________________________
CITY_____________________STATE____________ZIP_________
For consideration mutually agreed upon, and received by me, 1, the undersigned, hereby irrevocably consent to and authorize the use and reproduction by you, or anyone authorized by you, of any and all slides or photographs which you have this day taken of me, negative or Positive for any purpose whatsoever, without further compensation to me. All negatives and positives, together with the prints shall constitute your property, solely and completely.
I am over 18 years of age. YES_________ NO_________
DATE OF BIRTH _______/_______/_______
MODEL NAME _________________________________________
Please Print
ADDRESS:_____________________________________________
CITY_____________________STATE____________ZIP_________
PHONE:_______________________________________________
MODEL NAME _________________________________________
Signature