Release Form

Release Form
Thank you for choosing Lush Media Productions.

Our dedication to maintaining the privacy of our clients is our highest priority.

All Submissions will be used for training purposes only and in no way released to the public.

Information and submissions will are confidential.

Once form is submitted, a representative from Lush Media Productions will be in contact with you.

Thank You
Contact Information
Name

First NameLast Name
Date of Birth (Must be 18 years of age or older)

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Please indicate which style(s) of images you will be submitted for payment, select all that apply:
Please select which method of payment you would like to receive your payment:
Please upload a selfie

Cancelof
Statement of Understanding
- I, hereby acknowledge that this Image Release Form (hereinafter referred to as “Form”) became effective upon signing.
- I, hereby acknowledge that all images submitted to Lush Media Productions are of myself, not previously edited, and captured by myself or by someone in trust.
- I, hereby authorize Lush Media Productions to edit, change, copy, and make any use of all images of me to be used for training purposes.
- I, hereby acknowledge for confidentiality purposes; my personal information will not be used in association with any images submitted to Lush Media Productions.
- I, hereby acknowledge that all submitted images will be vented by Lush Media Productions, and only the images that meet the training criteria will be selected and used of training purposes.
- I, hereby acknowledge that I will only be entitled to payment for images selected for training purposes by Lush Media Productions.
- I, hereby acknowledge the image entitlements as dictated below:
  - Fully Clothed = $0.50 per image
  - Swimwear = $1.00 per image
  - Lingerie = $1.00 per image
  - Partial Nude = $2.50 per image
  - Sensual Fully Nude = $5.00 per image
  - Erotic Fully Nude = $10.00 per image
- I, hereby acknowledge that payment will only be recieved in $20 CAD increments. No payment will be given until entitlement is equal to $20 CAD.
- I, hereby acknowledge upon the submission of my images, I consent to such materials becoming the sole property of Lush Media Productions and that I will no longer be entitled to them.
- I, hereby release all rights to any, but not limited to, claims, rights, demands, and/or any causes of action by me or my representatives, heirs, or anyone else.
- Furthermore, I hereby waive my right to any additional royalty or any other compensation regarding the usage of the images referred to in this Form.
Please Sign Below
By signing this document, I hereby acknowledge that I have fully read and understand this form and all above information stated above is true.
Thank You for your Submission.

Someone from our office will be in contact with you shortly.
Should be Empty:

Release Form

Contact Information

Statement of Understanding

Please Sign Below

Thank You for your Submission.