Fillable Printable Model Release Form - AIPP

Model Release Form - AIPP

Model

Release Form

AUSTRALIAN INSTITUTE OF PROFESSIONAL PHOTOGRAPHY LTD A.C.N. 050 167 498 A.B.N. 77 050 167 498

AIPP NATIONAL OFFICE: PO BOX 372, NORTH MELBOURNE VICTORIA, 3051 TEL: 1800 686 696 FAX: (03) 9329 9933

THIS FORM MUST BE SIGNED BEFORE ANY PHOTOGRAPHY IS UNDERTAKEN

______________________________________________________________________

Name of Photographer…………………………………….. Job /Series No…………………

Name of Advertising Agency

Or Client (if assignment)…………………………………… Order No. ………………………

Description of Date of

Photography………………………………………………… Photography …………………..

______________________________________________________________________

I permit the photographer named above and his/her licensees or assignees to use the

photograph(s)and/or drawings therefrom and any other reproductions or adaptations

therefrom either complete or in part alone or in conjunction with any wording and/or

drawings for all uses including publicity and/or merchandising and/or editorial purposes

in any country. Unless otherwise agreed the photograph(s) and any drawings or

adaptations thereof shall be deemed to represent an imaginary person. No changes to

the terms of this model release are accepted unless agreed in writing by the

photographer, his/her assignees or licensees or myself.

I understand that I do not have any interest in the copyright to the photograph(s) nor

shall I receive any further payment.

I am over 18 years old. (Models who are under 18 years of age must provide evidence

of consent by a parent or guardian to this model release.)

Name of Model Agency (if any)

……………………………………………………………………………………..…………

Name of Model (capital letters)

…………………………………………………………………….………………………….

Address of Model

…………………………………………………………………………………………..……

Signature of Model ……………………………………………………Date …………………

Signature of Parent or Guardian …………………………………… Date …………………

(if model under 18)

Witness ……………………………………………………………….…Date …………………

This is a basic Model Release. The AIPP suggests you follow your solicitor's advice for your specific

requirements.