Model Release for Children
For good and valuable consideration, the receipt and legal sufficiency of which is hereby acknowledged,
I
*
First Name
Last Name
hereby grant to Diamond Studio Photography (the “Photographer”), the Photographer’s assigns, and those persons acting with the Photographer’s authority and permission, the right to take and create photographs/videos and other still and/or moving images, (in all formats) and other graphical depictions incorporating my likeness, in any and all media, whether now known or hereafter created (the “Content”).
I hereby agree that all rights in and to the Content, including the copyright, are and shall remain the sole property of the Photographer, free and clear from any claims by me or anyone acting on my behalf.
The Photographer’s rights include, but are not limited to, the rights, in perpetuity, to: Use, re-use, publish, and re-publish the Content; Alter, modify or otherwise change the Content in any manner the Photographer desires; Combine the Content with textual matter and/or with other pictures and/or media; and, Use the Content for illustration, promotion, art, editorial, advertising, trade, publishing, or any other purpose whatsoever.
I hereby release, discharge, and agree to hold harmless the Photographer, the Photographer’s heirs, legal representatives and assigns, and all persons acting under the Photographer’s authority or those for whom he/ she is acting, from any liability by virtue of any use of the Content or any changes or alterations made thereto.
I
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First Name
Last Name
warrant and represent that I am the father/mother/guardian (circle one) of the model named below:
Child's name
*
First Name
Last Name
I have read the above authorization, release and agreement, prior to its execution, and I am fully familiar with the contents thereof. This release shall be binding upon me and my heirs, legal representatives and assigns.
*
I agree
Photographer's Information:
Name: Diamond Studio Photography
Address: 1349 Coleman Crescent
City: Innisfil
State: Ontario
Zip/Postal Code: L9S 0G5
Phone: (647) 526 - 1202
Email: diamondstudio2017@gmail.com
Model's information:
Child's name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Date
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-
Month
-
Day
Year
Date Picker Icon
Father/mother/ guardian signature
*
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