Photographer Model

Model Release

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

I_____________________________________________________ [model name]

hereby grant _______________________________________________

(the “Photographer/Filmmaker”), his heirs, legal representatives, and assigns,

those for whom the Photographer/Filmmaker is acting, and those acting with

his authority and permission, the irrevocable and unrestricted right and permission

to copyright, in his own name or otherwise, and use, re-use, publish, and re-publish

photographic portraits or pictures or video of me or in which I may be included,

in whole or in part, as part of a composite or distorted in character or form,

without restriction as to changes or alterations, in conjunction with my own or a fictitious name, or reproductions there of in color or otherwise, made through any medium at his studios or elsewhere, and in any and all media now or hereafter known for illustration, promotion, art, editorial, advertising, trade, publishing, or any other purpose whatsoever. I also consent to the use of any printed/video matter in connection 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 the Photographer/Filmmaker, 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 use in composite form, whether intentional or otherwise that may occur or be produced in the taking of such photographic portraits or pictures or video or in any subsequent processing thereof, as well as any publication thereof, including without limitation any claims for libel or invasion of privacy.

I hereby warrant that I am of full legal 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.

Photographer Model

Name (print) _________ ____________ __________ __________ Name (print) _____________________________________

Shoot Date _________ Signature _______________________ Date ____________Signature _______________________

Phone ______________ Address ______________________ Phone ____________ Address ______________________

City ____________________ State _______________. Zip _____ City __ _____________ _ State ___________ Zip ________

Country _______________ Email: _ ______________________ __ Country __ _______ _____ Email: _____________________

Shoot location _________________________________________ Date of Birth _____________________________________

Shoot Date _________ Shoot Description ____________________________________________________________________

Witness

Name (print) ____________________________________________Date _______________ Signature ___________________

Shoot Description/Reference __________________________________________________________________________________

Russian

Я, _________________________________________________________________________________________________,
за вознаграждение _Диск с фотографиями/видео_ предоставляю полное и исключительное право _________________ _________________________________________ публиковать мои фотографии и видео, на которых я изображен(а), полностью или фрагментарно, в цвете или нет, под моим или вымышленным именем. А также предоставляю полное и абсолютное право использовать фотографии и видео с моим изображением на выставках, для рекламы, в печати или любых других целях, не противоречащих действующему законодательству. Я отказываюсь от права исправлять фотоснимки и видео или вмешиваться в право автора публиковать мои фотографии и видео. Разрешаю подработку моих фотографий и видео, ретуширование, затемнение, искажение и изменение изображения, применение оптических иллюзий, использованных в композициях, как преднамеренно, так и непреднамеренно в процессе подготовки публикации окончательного варианта фотографии и видео.

Я подтверждаю, что не буду оспаривать авторские и имущественные права на эти фотографии и видео.

Настоящим я удостоверяю, что являюсь совершеннолетним(ней) и имею полное право заключить настоящее соглашение. Я подтверждаю, что полностью ознакомлен(а) с вышеупомянутым разрешением, версией и соглашением до их подписания.

Подпись _______________________________ Дата _________________

Адрес _____________________________________________________________________________________________________

Свидетель __________________________________________________________________Подпись_______________________