Model Consent & Release Form

Model Consent & Release Form

Photographic and video images for artworks created by Mary MacGregor-Reid
I agree to have my likeness included in artworks created by artist Mary MacGregor-Reid (for example: video, photograph and images created thereof for example: sculptures) and used in promotion or publication of said artworks. I grant full copyright to the artist Mary MacGregor-Reid and those acting with her legal authority and permission. I agree that my renumeration will be in the form of an image of my choice from a selection chosen by Mary MacGregor-Reid, printed at Fine Art quality, approximately A3 size (420x297mm) and signed by the artist.
Model Name
Model Phone Number
E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Authorisation*

I have read and understand the terms of this model release with artist Mary MacGregor-Reid
Signature

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