model release - _no name to be used Date Name(print Address...

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Permission To Use Pictures In consideration for value received, receipt whereof is acknowledged, I hereby give _________________________________________________[photographer’s name] the absolute right and permission to publish, copyright and use pictures of me in which I may be included in whole or in part, composite or retouched in character or form, in conjunction with (initial those applicable): _______my own name _______a fictitious name
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Unformatted text preview: _______no name to be used Date:_____________________________________ Name (print):_______________________________ Address:__________________________________ Phone: ____________________________________ Signature:__________________________________ ______ If the person photographed is under 18, I certify that I am his or her parent or legal guardian and I give my consent without reservation to the foregoing on his or her behalf....
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