Cooper Works Creative Image Release Form
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Format: (000) 000-0000.
Date
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Day
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Month
Year
Date
Upload a clear photo of your face (for identification only)
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Signature
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In signing this form, I hereby assign full copyright of the photographs taken of me to Gary Cooper (the Photographer) of Cooper Works Creative together with the right of reproduction either wholly or in part. I grant to the Photographer the permission to use the above-mentioned photographs either separately or together, either wholly or in part. The Photographer may have unrestricted use of these for whatever purpose, including advertising, gallery exhibitions, Print publications, Digital and web-based marketing (including websites and social media platforms), Promotional materials, Commercial advertising, with any retouching or alteration without restriction. I agree that the above mentioned photographs and any reproductions shall be deemed to represent an imaginary person, and further agree that the Photographer may use the above mentioned photographs or any reproductions of them for any advertising purposes or for the purpose of illustrating any wording, and agree that no such wording shall be considered to be attributed to me personally unless my name is used. I undertake not to prosecute or to institute proceedings, claims or demands against either the Photographer or their agents in respect of any usage of the above mentioned photographs. I hereby release the Photographer named above from all claims and liability relating to images, video or photographs taken of me. Identification I consent to the Photographer retaining one reference photograph of me for internal identification and record-keeping only. This image will not be published without my separate consent. Privacy Information collected is held by Cooper Works Creative solely to administer this release and for model identification. It will not be sold or disclosed to third parties without consent, except as required by law (Privacy Act 2020, NZ).
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