Stacy Boyer Photography
570-541-2039 sboyerphotography@gmail.com www.stacyboyerphotography.com
As the photographer, by submitting this form I agree that I am the original creator of this image and that the image was not taken at a paid conference or model shoot workshop.
MODEL RELEASE
AN ADULT MUST FILL THIS OUT AND SUBMIT FORM. Please read each question entirely.
1. I agree that the photographer has my permission to submit images of me, of family member(s) and of anyone else appearing in the images, to a national print competition hosted by Senior Year Magazine/Teen Years Magazine/Infinity Photography Magazine and understand and agree that these images, if selected, will be published in a national/international print magazine/website.
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I agree/acknowledge
2. Further, I understand and agree that in additional to publishing the images, they also have the right to publish model's name and photographer's name in connection with the images as well.
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I agree/acknowledge
3. I acknowledge and agree that should the images be chosen to appear in the magazine, on the website, blog or in any other medium, that models, relatives of models and/or photographer will not be entitled to any compensation.
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I agree/acknowledge
4. I hereby release Senior Year Magazine, Teen Years Magazine, Infinity Photography Magazine, my Photographer, related representatives and assignees from any and all claims and demands arising out of or in connection with the uses set forth herein, including, without limitation, any and all liability arising out of publishing the images.
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I agree/acknowledge
5. I acknowledge that I am the adult representing the individual(s) appearing in the images, and am in agreement with the releases, consents and covenants contained in this Model Release.
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I agree/acknowledge
6. I further acknowledge that I have read this release in its entirety, fully understand it, and I have resolved to my satisfaction, all questions concerning its content.
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I agree/acknowledge
PERSON/PERSONS APPEARING IN IMAGES
FILL THIS OUT FOR EACH INDIVIDUAL APPEARING IN IMAGES. IF MULTIPLE PEOPLE (FROM DIFFERENT FAMILIES) APPEAR IN AN IMAGE, EACH "FAMILY UNIT" MUST FILL OUT A SEPARATE FORM
PERSON NUMBER 1. - First and Last name of MODEL who appears in images.
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First Name
Last Name
PERSON NUMBER 2. - First and Last name of MODEL who appears in images.
First Name
Last Name
PERSON NUMBER 3. - First and Last name of MODEL who appears in images.
First Name
Last Name
PERSON NUMBER 4. - First and Last name of MODEL who appears in images.
First Name
Last Name
PERSON NUMBER 5. - First and Last name of MODEL who appears in images.
First Name
Last Name
PERSON NUMBER 6. - First and Last name of MODEL who appears in images.
First Name
Last Name
PERSON NUMBER 7. - First and Last name of MODEL who appears in images.
First Name
Last Name
Adult Consent
An Adult must sign. If you are submitting for Senior Year Magazine or Teen Years Magazine, a parent must sign. For Infinity Photography Magazine, one adult must sign on behalf of the person(s) in the images)
Adult Name
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First Name
Last Name
Adult Signature
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Date
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Month
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Day
Year
Date
Adult Email Address
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example@example.com
Relationship to model (s)
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THIS SECTION IS FOR SENIOR YEAR MAGAZINE AND TEEN YEARS MAGAZINE ONLY.
I
F
YOU ARE SUBMITTING IMAGES FOR INFINITY PHOTOGRAPHY MAGAZINE, SKIP TO THE SUBMIT BUTTON A THE BOTTOM.
MODEL NAME AND HIGH SCHOOL GRADUATING YEAR (IF SUBMITTING FOR SENIOR YEAR MAGAZINE OR TEEN YEARS MAGAZINE)
Name of model
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High School Graduating Year
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Name of model
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High School Graduating Year
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Name of model
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High School Graduating Year
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Click below to submit this form. It will automatically be sent directly to your photographer for their records.
Thank you!
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