Fillable Printable Model Release Form Template

Model Release Form Template

MODEL RELEASE FORM

To the photographer: ___________________________________________________

(name)

Address: _____________________________________________________________________

_____________________________________________________________________

________________________________________________ Phone: ____________

From the model: ________________________________________________________ (name)

Address: _____________________________________________________________________

_____________________________________________________________________

________________________________________________ Phone: ____________

Photographs taken on _________________________________________________ (date)

at __________________________________________________________________ (location)

In exchange for receiving (check/tick as appropriate):

□ modelling fee in the amount of _______________ □ free prints

I, the model, grant you, the photographer, usage of the photographs subject to the following conditions:

● I understand that the photographs taken of me during this sessions can be used wholly or in

part in any publication (commercial or otherwise), portfolio or public display (delete any that

aren't applicable).

● The photographs may be used to represent an imaginary person and any wording associated

will not be attributed to me unless my name is specifically mentioned.

● Any special conditions on usage agreed between the model and photographer:

________________________________________________________________________

Model: ____________________________________ Photographer: ____________________________________

both parties to sign here to agree these special conditions.

I acknowledge that by signing this form, subject to the usage restrictions above, I give up all claim of

ownership of the photographs, and assign copyright to the photographer named above. No further

payment will be due. Use of the photographs may be granted to third parties, however the

photographs will remain the property of the photographer.

I have read this form carefully and fully understand the implications. I am 18 years old or over.

Signed: __________________________________(model) Date: ____________________

If the model is under 18 years of age, a parent or legal guardian must sign:

Parent/guardian: ________________________________ Date: ____________________

Address: _____________________________________________________________________

________________________________________________ Phone: ____________