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Menagerie Photography – Model Release form

This form is required to accompany entries where a readily identifiable person has been used as a subject. It is required as photographs and film might be displayed in public spaces, social media or internet, and may be used in publications, marketing or educational materials promoting Menagerie Photography.

I, (the undersigned) hereby (grant or deny) Menagerie Photography Studios, his/her legal representatives and assigns (including but not limited to any agency, client, or publication), irrevocable permission to publish photographs and/or film of me taken at Menagerie Photography Studio, Lisbon CT   on the date specified below.

I understand that these images may be used in publications, marketing and educational materials to promote Menagerie Photography business. Furthermore, I will hold harmless the aforementioned photographer and his/her legal representatives and assigns, from any liability by virtue of minor cropping that may be required, and color and exposure shifts that may occur in reproducing this photograph.

    Model's Name:

    Physical Address: Email Address:

    Date of Photo Session: Today's Date:

    (ONLY REQUIRED IF MODEL IS UNDER THE AGE OF 18)

    I am the parent or legal guardian of the minor named above, and have legal authority to execute this release on his/her behalf. I have read and fully understand the contents of this release, and consent to the use of said photographs and film based on the contents of this release.

    Parent/Legal Guardian Name:

    GRANT OR DENY PREFERENCES

    I Grant or Deny the use of some or all of my photograph(s) and/or video(s):

    Photo(s):

    Video(s):

    Before and After(s):

    If "Some" was selected, Describe:

    By checking the agreement box below, I am stating that I agree to the terms and conditions stated in this document and that I am signing the document using an electronic signature, pursuant to these terms and conditions.

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