MODEL RELEASE
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the model 18 years of age or older?
*
YES
NO
Grant of Rights. For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, I hereby grant Heron Cove, LLC, dba Katie Dowens Photography (the Photographer), the irrevocable and unrestricted right to photograph, record, and otherwise capture my image, likeness, appearance, and persona (“Images”).I authorize the Photographer to use, reproduce, publish, distribute, display, modify, crop, edit, composite, and otherwise exploit (to make lawful use of the images in any way permitted by the agreement) the Images in any manner and medium, now known or hereafter devised, including but not limited to: Print materials, Advertising and marketing, Editorial and promotional use, Social media and digital platforms, Websites and online publications, Fine-art prints and print sales, Books, including photographic and coffee-table books, Exhibitions, galleries, and portfolios. This authorization is worldwide, perpetual, royalty-free, and non-exclusive.
*
I AGREE
Ownership & Copyright. I understand and agree that all Images are the sole property of the Photographer and are protected by copyright law. I waive any right to inspect or approve the finished Images or the use to which they may be applied.
*
I AGREE
No Compensation. I understand and agree that I am not entitled to monetary compensation unless otherwise agreed to in writing.
*
I AGREE
Courtesy Digital Image License Terms: If this box is selected, Photographer agrees to provide Model with one (1) high-resolution digital image, selected solely by the Photographer, as a courtesy. Model acknowledges and agrees that: The image is provided for personal, non-commercial use only permitted uses include personal display and personal social media accounts. The image may not be sold, licensed, transferred, assigned, gifted, or distributed. The image may not be used for advertising, promotion, branding, endorsement, or any commercial purpose. The image may not be altered, edited, filtered, or modified without written permission. Copyright remains exclusively with the Photographer. Delivery of this image does not grant ownership, licensing rights, or approval rights. This courtesy does not limit or affect the Photographer’s rights to publish, sell, license, or otherwise exploit (to make lawful use of the images in any way permitted by the agreement) any images.
YES
Waiver of Royalties and Proceeds. Model expressly acknowledges and agrees that they shall not be entitled to any compensation, royalties, residuals, profits, or proceeds arising from the use, publication, reproduction, distribution, sale, licensing, or other exploitation of the Images, including but not limited to: The sale of books or photographic volumes, the sale of fine-art prints (limited or open editions), Gallery exhibitions or installations, online or in-person print sales, Licensing of Images to third parties, Model understands and agrees that all rights, revenues, and proceeds derived from the Images belong solely to the Photographer and waives any present or future claims related thereto.
*
I AGREE
Release of Liability. I release and hold harmless the Photographer, Heron Cove LLC, Katie Dowens Photography, and their members, agents, licensees, successors, and assigns from any and all claims arising from the use of the Images, including claims for defamation, invasion of privacy, or right of publicity.
*
I AGREE
Governing Law: This Agreement shall be governed by and construed in accordance with the laws of the State of North Carolina.
ADULT MODEL SIGNATURE
Date
-
Month
-
Day
Year
Date
MINOR MODEL & PARENT / LEGAL GUARDIAN CONSENT
Date
-
Month
-
Day
Year
Date
PARENT/LEGAL GUARDIAN FULL NAME
First Name
Last Name
Email OF PARENT/LEGAL GUARDIAN
example@example.com
RELATIONSHIP TO MINOR
MINOR'S DATE OF BIRTH
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