Standard Adult Model Release:
In consideration of my engagement as a model, and for other good and valuable consideration herein
acknowledged as received, I hereby grant ________, (Photographer), his heirs, legal representatives, and
assigns, those for whom the Photographer is acting, and those acting within his authority and permission,
the irrevocable and unrestricted right and permission to take, use, re-use, publish and republish
photographic portraits or pictures of me or in which I may be included, in whole or in part, or composite or
distorted in character or form, without restriction as to changes or alterations, in conjunction with my own
or a fictitious name, or reproduction thereof in color or otherwise, made through any medium at a studio
or elsewhere, and in any and all media now or hereafter known for illustration, promotion, art, editorial,
advertising, trade, or any other purpose whatsoever. I also consent to the use of any published matter in
conjunction therewith.
I hereby waive any right that I may have to inspect or approve the finished product or products and the
advertising copy or other matter that may be used in connection therewith or the use to which it may be
applied.
I hereby release, discharge and agree to save harmless Photographer, his heirs, legal representatives and
assigns, and all persons acting under his permission or authority or those for whom he is acting, from any
liability by virtue of any blurring, distortion, alteration, optical illusion or us in composite form, whether
intentional or otherwise, that may occur or be produced in the taking of said picture or in any subsequent
processing thereof, as well as any publication thereof, including without limitation any claims for libel or
violation of any right of publicity or privacy.
I hereby warrant that I am of full age and have the right to contract in my own name. I have read the above
authorization, release and agreement, prior to its execution and I am fully familiar with the contents thereof.
This release shall be binding upon me and my heirs, legal representatives, and assigns.
_______________________________________________
Date
_______________________________________________
Name
_______________________________________________
Address
_______________________________________________
Witness